just to tack onto this, the reason central lines are often used...

just to tack onto this, the reason central lines are often used is that cancer drugs are usually quite nasty and damage cells they come into contact with, including ones they are not meant to kill.

Peripheral lines are great but they have two major problems. The first is what’s called extravasation. This is when the cannula is inserted and misses the vein and the drug is administered into the subcutaneous tissue. This is nasty and can cause a lot of damage, pain and is difficult to fix. This is less of an issue with central access as you are inserting into a larger diameter vessel so it’s “harder to miss”. Insertion of central lines is also sometimes done with the guidance of radiographic imagine.

the second problem is chemotherapies are often irritants to vascular tissue. Administering them into a larger vessel means there is higher blood flow where the drug is delivered, meaning the drug is effectively diluted more and causes less irritation than it would when delivered into a smaller vessel which is carrying less flow and thus results in a higher concentration of drug at the insertion site.

now, for most purposes, peripheral lines have many many advantages over central lines, especially around patient preference and quality of life. However as mentioned above they are not perfect. Altered formulations of Zantrene to facilitate peripheral insertion would be looking at these factors to make them more suitable for peripheral administration.

now this isn’t usually an extremely difficult task. I don’t mean to say it’s easy, but it’s not something that should take many years like some of the other more clinically demanding aspects of drug commercialisation.