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J Vasc Interv Radiol. 2013 Aug;24(8):1201-7. doi: 10.1016/j.jvir.2013.03.034. Epub 2013 Jun 2.

Barriers to drug delivery in interventional oncology.

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Department of Imaging, Division of Vascular Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.


Although much attention has been paid to mechanisms of anticancer drug resistance that focus on intracellular processes that protect tumor cells, it has recently become increasingly evident that the unique features of the tumor microenvironment profoundly impact the efficacy of cancer therapies. The properties of this extracellular milieu, including increased interstitial pressure, decreased pH, hypoxia, and abnormal vascularity, result in limited drug efficacy; this finding is true not only for systemic chemotherapy but also for catheter-based therapies, including chemoembolization and radioembolization. The present review summarizes the barriers to drug delivery imposed by the tumor microenvironment and provides methods to overcome these hurdles.


DEB; ECM; HIF; IFP; RF; VEGF; drug-eluting bead; extracellular matrix; hypoxia-inducible factor; interstitial fluid pressure; radiofrequency; vascular endothelial growth factor

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