Biomaterial-Mediated Drug Delivery in Primary and Metastatic Cancers of the Bone

Cancer can either originate in the bone itself or it is also a major site for metastasis from solid tumors, which frequently have their origins in the breast, prostate or lung. The development of cancer in the bone environment can co-opt many of the normal physiological processes to ensure colonisation and growth in the bone tissue environment. This gives rise to a number of skeletal related events (e.g. pain and fracture) and considerable patient morbidity. Treatment is extremely challenging due to the bone physiology and the heterogeneous and dynamic nature of many tumors. Multidisciplinary management involving chemotherapy, surgery and radiation has enhanced patient’s life expectancy and quality of life. However, outcomes have not improved in recent decades and the prognosis is especially poor in cases of recurrent or metastatic disease. This underscores the critical need to identify novel therapies or indeed to enhance the delivery of existing and emerging drug treatments. In this chapter we review physiological and mechanistic considerations in the development of novel drug delivery approaches with particular emphasis on concepts in bioengineering and biomaterials science. We explore the diversity of technologies and targeting approaches that have been investigated to enhance the delivery of a range of complex cargoes, in the treatment of primary cancers and metastatic bone disease, with a view to summarising the benefits, limitations and current state of progress of biomaterial strategies to improve patient outcomes.