Reengineering the Tumor Vasculature: Improving Drug Delivery and Efficacy.
Level 5 - mechanism / opinion, no new human data
Narrative review / mechanism-based reasoning with no primary human data
PubMed 29606306 · doi:10.1016/j.trecan.2018.02.010
What was done
Narrative review summarizing the biomechanical and physiological barriers to drug delivery in solid tumors—including extracellular matrix deposition, solid stress, vessel leakiness, and elevated interstitial fluid pressure—and outlining engineering approaches to reengineer the tumor microenvironment.
What was found
No quantitative findings or numerical data are reported in the abstract. The authors describe qualitatively that solid stress compresses vessels, leakiness impairs perfusion, and the resulting hypoxia drives resistance and metastasis, while reporting that vascular reengineering approaches have begun translating from bench to bedside.
Why it matters
Synthesizes the physical and biological mechanisms governing drug delivery failure in solid tumors and highlights vascular and microenvironmental normalization as a strategy to enhance existing cancer therapies.
Limits
As a narrative review, it presents conceptual mechanisms rather than primary empirical data or a systematic review methodology. The abstract provides no specific clinical outcome metrics, patient sample sizes, or quantitative effect sizes.
Cited by
- supports Solid tumors are often resistant to systemic chemotherapy because they frequently grow far from blood vessels and are hypoxic, impairing drug delivery.