Thursday, 20. March 2014

Lung cancer-new field of application for nebuliser?

A Spanish working group showed the extraordinary efficacy of local application of dobesilate by inhalation, in a 78 years old patient with squamous cell lung carcinoma...

... (L-SCC). The drug, 500 mg dobesilate, was administered twice a day by eFlow rapid nebuliser and was well tolerated. After 5 days, bronchoscopy showed a drastic reduction of tumour mass. The patient was subsequently discharged, and resumed his habitual life.
Lung cancer is one of the leading causes of cancer related death in developing countries. Approximately in 85 % of lung cancer patients, non-small-cell-lung cancer (NSCLC) is diagnosed. Two of the most predominant subtypes are adenocarcinoma and squamous cell carcinoma which comprise 40 % and 25 % of NSCLC.
In the case of squamous cell lung carcinoma, targeted-therapies have not yet been fully developed, therefore exploring new pathways for the development of new therapeutic options are urgently needed, according to the authors.

Figure: Bronchoscopic findings of the effect of inhaled dobesilate in lung squamous cell carcinoma. 
Shows a bronchoscopy at baseline.Shows a similar bronchoscopic area of the right principal bronchus taken after 5 days inhalation therapy with dobesilate via eFlow nebuliser.

On the basis of positive experiences in patients with skin neoplasms treated with dobesilate, the working group decided to treat patients with squamous cell lung carcinoma (L-SCC) with nebulised dobesilate. Dobesilate is an inhibitor of fibroblast-growthfactor (FGF)-driven pathways. Beyond this, dobesilate shows anti-mitotic and anti-inflammatory effects, promotes apoptosis and inhibits the formation of new blood vessels in tumours. All these properties may account for the efficacy of the treatment. The scientists expect that, according to the presented results, dobesilate could be a therapeutic option in lung cancer patients with low performance or serious complications. This should be subject of further testings.
Cuevas P et al. 2012. BMJ Case Reports