Year: 2018
Type: dissertation
Abstract: Inspired by early work indicating nanometre-scale macromolecules can accumulate in tumours, nanomedicines were developed with intentions of improving cancer-killing efficacy and reducing systemic toxicity typical of traditional chemotherapies. This research first evaluates evidence provided to FDA and EMA regulators in order for cancer nanomedicines to be granted marketing approval, and then consults mature clinical data via health technology assessments to synthesize judgments of clinical benefit with respect to overall survival, safety, and health-related quality of life (HRQOL). Findings indicate that every marketed cancer nanomedicine— eight of nine being liposome technologies—demonstrates comparative clinical benefit on at least one dimension, that improvements in overall survival frequently come at the expense of safety, and that HRQOL is generally conserved or improved versus comparator therapies. Sparse data and inconsistency in HRQOL reporting practices were major deficiencies among the documents consulted and represent key barriers to providing patients evidence that can inform treatment decision-making.
Source: TSpace (University of Toronto)
Author: Michael Welch Freeman
Language: English
Subfield: Biomaterials
Field: Materials Science
Domain: Physical Sciences
Open Access status: green
Funder: University of Toronto
OpenAlex ID: W3093682603