International Journal of PharmTech Research CODEN (USA): IJPRIF ISSN : 0974-4304 Vol.2, No.1, pp 834-842, Jan-Mar 2010 LIVER CANCER: DIFFERENT APPROACHES FOR TARGETING C.S.RAMAA*, K.N. TILEKAR, V.M. PATIL Department of Pharmaceutical Chemistry, Bharati Vidyapeeth’s College of Pharamcy, Sector 08, CBD Belapur, Navi Mumbai-400614, India *Corres.author: kalpana.tilekar@gmail.com ABSTRACT : Cancerous tumors of the liver can be primary cancer – cancer starting in the liver itself or secondary or metastatic cancer – cancer which started in another part of the body and has spread to the liver. Surgery is the most effective treatment for primary liver cancer, but this is not always possible due to the size or position of the tumor and hence chemotherapy is used sometimes to treat these cancerous tumors that cannot be removed. Chemotherapy is also given following surgery to prevent relapse of the cancer. Chemotherapeutic agents used in treatment of liver cancer are not specific for the treatment of liver cancer and suffers from the problem of serious toxicities to the normal cell of the liver as well as to other cells. This can be overcome by targeting drug to the liver by different approaches such as by designing prodrugs which may be distributed to all body tissues but cleaved only in liver or tethering a moiety which binds with the receptor on liver cells. New drugs are being developed that work in a different way from standard chemotherapeutic drugs. Key words : Liver cancer, Targeting Strategies. 1. INTRODUCTION 1 Cancerous (malignant) tumors of the liver can be primary cancer – cancer starting in the liver itself or secondary or metastatic cancer – cancer which started in another part of the body and has spread to the liver. There are two different types of primary liver cancer. First type is Hepatoma or hepatocellular carcinoma (HCC) which arises from the main cells of the liver (the hepatocytes). This type is usually confined to the liver, although occasionally it spreads to other organs. It is more common in men and occurs mostly in people with a liver cirrhosis. The second type of primary liver cancer is Cholangiocarcinoma or bile duct cancer is so called because it starts in the cells lining the bile ducts. Cholangiocarcinoma is more common in women. Some primary tumors in the liver are non-cancerous (benign) and do not spread to other parts of the body. They are usually small and may cause no symptoms. They are often discovered by chance during operations or investigations for other conditions. Unless they are causing symptoms they do not usually need to be removed. 2. TREATMENT OPTIONS 2.1 SURGERY 2 During the past decade, one of the major changes in the field of oncology has been in the surgical approach to primary and secondary cancer of the liver., but this is not always possible due to the size or position of the tumor. It is also not possible to operate if the cancer has spread beyond the liver. If the liver is severely damaged by cirrhosis it may not be safe to have surgery, but can only be done in a very few cases when the tumor is small (less than 5cm) or there are less than three tumors, all smaller than 3cm in size. Various types of surgeries that can be performed depending on tumor size, tumor location includes liver resection, lobectomy, liver transplant, radio surgery and theraspheres. 2.2 TUMOR ABLATION 3 This type of treatment is used for tumors less than 5cm (2 inches) in diameter. Liquids such as alcohol (ethanol) or acetic acid are injected through the skin and into the tumor. The liquids destroy the cancer cells. Ultrasound can be used to guide the needle