Selective or targeted gene/drug delivery for liver tumors: advantages and current status of local delivery.

There are various disorders involving the liver. They include metabolic diseases, hepatitis, liver cirrhosis and cancer, the latter of which may be the most serious. Delivery of therapeutic genes or drugs should be targeted to either one of the following cells in the liver: hepatocytes, Kupffer cells and tumor endothelial cells, or to the tumor cells themselves. To maximize the therapeutic effect and minimize systemic toxicity or nontarget injuries, the sufficient amount or dose of genes or drugs should be specifically delivered to a target, with minimal exposure in their active forms to nontarget cells. There are diverse strategies to improve selective delivery or targeting efficiency. In this article, we present potential new therapeutic strategies and clinical developments for liver cancer, with a focus on the progress in the localized delivery of therapeutic agents using image-guided procedures.