Intrathecal Drug Delivery Novel Dosing Parameters

This presentation focuses on precision targeted drug delivery (TDD) for cancer pain management, emphasizing recent advances in dosing strategies and intrathecal pharmacology. Dr. Hermant Kalia highlights three core pillars for improved outcomes: infusion settings, drug chemistry, and CSF flow dynamics. The updated 2024 PACC guidelines provide structured recommendations for medication selection, catheter tip placement, and patient-specific factors, stressing system-based considerations like refill logistics. Zyconotide, initially challenged by side effects, now benefits from innovative approaches such as scheduled or patient-controlled boluses, reduced concentrations, and higher infusion rates to maintain efficacy while minimizing toxicity. Precision TDD is evolving toward individualized, guideline-driven, and optimized dosing paradigms.