Loco-regional Therapy: A Promising Avenue for Treating Oral Cavity Cancers

Oral cancer is rapidly rising in India and ranks first in terms of number of cases in men. Affecting nearly 16.1% of men in India, more than 1,20,000 new cases have been observed. Due to several factors like smoking, consumption of tobacco and betel quid’s, it causes mutations in the cells, that ultimately leads to development of cancer in the lip or oral cavity region. Though the survival rate with early stage cancer is high, premalignant conditions and early stage cancers can remain unnoticed and escalate into late stage cancers in which survival is only upto 52%. Commonly used therapies are cytotoxic with tendency to kill cancerous cells as well as normal cells. The dose related toxicity and lack targeting towards cancer cells has led to serious side effects along with low patient compliance. Therefore, it is essential to address these issues for better therapeutic outcomes in patients.

One potential approach is to use lower dose of drugs and precisely deliver these anti-cancer molecules in the microenvironment surrounding the cancer cells. This can be very well achieved using loco-regional delivery of drug wherein the drug molecule is delivered close to the region of disease. In cases of oral cavity cancers where there is presence of tumors or cancerous cells the developed therapy can be directly applied at the site of disease.

My doctoral research work aimed to focus on this avenue wherein we developed simple yet effective solution to address these challenges. The research work included use of targeted anti-cancer molecules that can specifically bind to receptors that are overexpressed over cancer cells as compared to normal cells. Considering the physicochemical properties of the anti-cancer molecule suitable nanoformulation composed of lipids was developed and these were incorporated in carbopol gel. The carbopol gel has properties of rapid absorption and mucoadhesiveness and improved nano drug delivery systems. When applied directly at the site of disease, it can be rapidly absorbed within the cancer microenvironment regions inside oral cavity and release the drug content. The research was able to yield positive outcomes in rat as animal model and thus established loco-regional therapy as an effective approach for management of oral cavity cancers.