NEW YORK, Oct 13 (Reuters Health) -- An aerosol spray may help to stop very early lung cancers from progressing, US researchers reported Wednesday at a meeting of lung specialists in Madrid, Spain.
Although the clinical work is very preliminary, in theory, aerosol therapy could offer an alternative to invasive lung surgery in early-stage disease, said Dr. James L. Mulshine of the National Cancer Institute (NCI) in Bethesda, Maryland, at the European Respiratory Society's annual meeting.
Advances in diagnostic technologies, such as spiral computed tomography (spiral CT) and autofluorescence bronchoscopy, have made the detection of early lung lesions easier. For example, spiral CT images the lungs so quickly that data are collected in a single breath hold, reducing the risk of error, Mulshine said. In autofluorescence bronchoscopy, the patient inhales a pigment that causes tissue to take on different colors depending on whether it is normal or malignant. Both techniques detect lesions that cannot be seen with conventional imaging modalities.
Meanwhile, the delivery capabilities for lung aerosols are improving rapidly, Mulshine said. This suggests that compounds such as concentrated retinoids, which are known to have activity in lung cancer, might be delivered directly to lung lesions with minimal side effects. This is an advantage because taking the drug by mouth has led to side effects. Inhaling an aerosol form of the compound also allows up to 100 times more of it to be delivered right to the lung lesion.
As an example of direct drug delivery, the NCI researchers are conducting a study of a retinoid mouthwash therapy in 57 patients with leukoplakia, a premalignant condition of the lining of the mouth.
Once results of that trial are in, the researchers will begin testing a retinoid aerosol in very early lung cancer in a trial involving up to 20 patients.
Potentially, an aerosol delivery system could treat the lining of the airways with medication in much the same way that cigarette smoke infuses this area with carcinogens. "We think this approach is going through the right door," Mulshine said.
