The goal of any drug delivery system is to provide a therapeutic amount of drug to the proper site in the body, to achieve promptly and then maintain the desired drug concentration. Conventional drug delivery system achieves as well as maintains the drug concentration with in the therapeutically effective range needed for treatment only when taken several times a day. This results in a significant fluctuation in drug level (Chien YM., 1992). The concept of designing specified delivery system to achieve selective drug targeting has been originated from the perception of Paul Ehrlich, who proposed drug delivery to be as a “magic bullet”. Controlled & Novel delivery envisages optimized drug in the sense that the therapeutic efficacy of a drug is optimized, which also implies nil or minimum side effects. It is expected that the 21st century would witness great changes in the area of drug delivery. The products may be more potent as well as safer. Target specific dosage delivery is likely to overcome much of the criticism of conventional dosage forms.

Purpose: We sought to identify factors predictive of development of radiation pneumonitis and pulmonary fibrosis following split course concurrent chemo irradiation for locally advanced non-small cell lung cancer (LA-NSCLC). Methods and Materials: We reviewed records of 108 patients treated with regimen of split course radiotherapy (median 60 Gy in 30 fractions) and concurrent chemotherapy for stage IIIa/IIIb NSCLC. Fishers Exact Test and Paired Student T Test were performed to identify factors predictive of development of any pulmonary toxicity (pneumonitis or fibrosis of any grade) and severe pulmonary toxicity (grade 3 or higher pneumonitis, grade 2 or higher fibrosis). Results: 56 patients (51.2%%) developed any toxicity; 22 patients (20.4%) developed severe toxicity. The following predictive factors were identified for any and severe pulmonary toxicity, respectively: reactive airway disease (RAD), age, RV % expected (EXP), PEF %EXP, FEV1/FVC ratio, smoking status; and RAD, FEV1 %EXP, FVC %EXP, FEV1/FVC %EXP, RV %EXP, FEF25/75 %EXP, PEF %EXP, S-GAW %, FEV1, FVC, and FEV1/FVC . Conclusions: Our overall rates of any and severe pulmonary toxicity are acceptable. History of RAD and active smoking are protective, whereas patients with severe COPD have increased risk. A trend was seen toward improved outcomes with the use of prophylactic steroid control medication. These results should be confirmed in the context of a prospective study.

Aim: As comorbidities may impact treatment decisions, prognoses and quality of care, this study determined the rate of comorbid cardiovascular diseases in patients with metastatic colorectal cancer (mCRC). Methods: From the PHARMO Record Linkage System in The Netherlands, all patients with a hospital discharge code for CRC and distant metastasis from 2000–2008 were selected. Prevalent cardiovascular comorbidities were assessed during the 12 months prior to the index date (the first discharge diagnosis defining metastases). Cardiovascular comorbidities were captured using cardiovascular drug use and hospital admission data. 2964 patients with mCRC were included in the analysis. Mean (± standard deviation) age at diagnosis was 68 (± 12) years and 53% were male. Results: Cardiovascular comorbidities were observed in 52% of patients. Of patients identified by drug use, the most commonly used agents were antithrombotic agents (54%), beta-blocking agents (46%), and agents acting on the renin-angiotensin system (45%). Of patients hospitalised for cardiovascular comorbidities, about one-third were hospitalised for cardiac dysrhythmia (39%), followed by congestive heart failure (19%) and hypertension (18%). Conclusions: Cardiovascular comorbidities are common in patients with mCRC, which is likely to be explained by the high mean age at diagnosis. Consideration of these conditions should be integral to the treatment strategy in individual patients with mCRC.