Pharmacokinetic profiles of cancer sonochemotherapy.

INTRODUCTION: Sonochemotherapy is a promising strategy for the treatment of cancer, however, there is limited understanding of its pharmacokinetics (PK). Area covered: The PK profile of sonochemotherapy is evaluated based on released data. Preclinical investigations suggest that the blood PK of sonochemotherapy is similar to chemotherapy when using free anticancer drugs. When using encapsulated drugs, a lower plasma level usually occurs; however, the ultrasonic release of drugs within a tumor may lead to drugs leaking into circulation, causing a rebound in the plasma drug level; a higher drug level is detected in certain healthy organs, however this depends mostly on the pharmaceutical formulation. Sonochemotherapy increases both the level and retention time of drugs in a tumor. Clinical trials of combined chemotherapy and high intensity focused ultrasound (HIFU) are evaluated from the perspective of preclinical PK: the intratumoral PK and drug interactions under insonation, and a protocol to set the interval between drug administration and insonation are lacking. Expert opinion: Insonation can alter the PK properties of chemotherapeutics, which may exacerbate the system and/or organ toxicity of anticancer drugs. Directly employing the PK parameters validated in conventional chemotherapy plays an important role in unsatisfactory clinical outcomes of chemotherapy combined with HIFU.