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Review
. 2024 Oct 20;5(11):e767.
doi: 10.1002/mco2.767. eCollection 2024 Nov.

Nanomedicine for cancer patient-centered care

Carlo Sorrentino  1   2 , Stefania Livia Ciummo  1   2 , Cristiano Fieni  1   2 , Emma Di Carlo  1   2
Affiliations
Review

Nanomedicine for cancer patient-centered care

Carlo Sorrentino et al. MedComm (2020). .

Abstract

Cancer is a leading cause of morbidity and mortality worldwide, and an increase in incidence is estimated in the next future, due to population aging, which requires the development of highly tolerable and low-toxicity cancer treatment strategies. The use of nanotechnology to tailor treatments according to the genetic and immunophenotypic characteristics of a patient's tumor, and to allow its targeted release, can meet this need, improving the efficacy of treatment and minimizing side effects. Nanomedicine-based approach for the diagnosis and treatment of cancer is a rapidly evolving field. Several nanoformulations are currently in clinical trials, and some have been approved and marketed. However, their large-scale production and use are still hindered by an in-depth debate involving ethics, intellectual property, safety and health concerns, technical issues, and costs. Here, we survey the key approaches, with specific reference to organ-on chip technology, and cutting-edge tools, such as CRISPR/Cas9 genome editing, through which nanosystems can meet the needs for personalized diagnostics and therapy in cancer patients. An update is provided on the nanopharmaceuticals approved and marketed for cancer therapy and those currently undergoing clinical trials. Finally, we discuss the emerging avenues in the field and the challenges to be overcome for the transfer of nano-based precision oncology into clinical daily life.

Keywords: drug delivery systems; nanomedicine; nanotechnology; personalized cancer treatments; precision oncology; targeted therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Graphic representation of the three main approaches of nanoimmunotherapy to precision oncology, which consist in: (1) targeting cancer cells (left compartment), which aim to induce immunogenic cell death, thereby triggering the release of tumor antigens and danger‐associated molecular patterns; (2) targeting the tumor microenvironment (top compartment) and re‐educate immunosuppressive cells, such as protumorigenic M2 macrophages, N2 neutrophils, or T regulatory cells, or inhibit the production of immunosuppressive/inflammatory mediators, such as TGF‐β, IL‐6, or VEGF or targeting cancer‐associated fibroblasts to reverse drug resistance, or enhance cytotoxic T lymphocyte and natural killer cell infiltration; (3) targeting the peripheral immune system (right compartment), to enhance tumor‐antigen presentation to dendritic cells, and cytotoxic T cell activation and proliferation in secondary lymphoid organs, thereby promoting anticancer immunity. Created using Microsoft PhotoDraw (version 2.0.0.0822).
FIGURE 2
FIGURE 2
Graphic representation of the different strategies that can be used to achieve an effective antitumor immunity and improve therapeutic outcomes of nanoparticle‐based anticancer immunotherapy. (1) Antigen delivery. Double‐lipid bilayer nanoparticles can deliver tumor‐associated antigens to DCs, promoting the activation and expansion of cytotoxic T cells that can target cancer cells. (2) Adjuvant delivery. Nanoparticles made of polymers with immunostimulatory properties can boost antitumor immunity, and biopolymer‐based materials, such as polysaccharides (chitosan/alginate), are widely used due to their lack of allergic reactions and toxicity. (3) Vaccine platforms. Lipid nanoparticles can serve as vaccine platforms for cancer immunotherapy, since they can convey tumor antigens or DNA/RNA sequences encoding for tumor‐specific antigens, promoting an adaptive immune response against cancer cells. (4) Immunomodulatory agents. Polymer‐based nanoparticles can be loaded with immunomodulatory agents, such as cytokines (IL‐2) or CpG oligodeoxynucleotides, to promote antitumor immune responses. (5) Imaging and monitoring the effectiveness of immunotherapy. Nanoparticles, especially liposomes, loaded with specific materials and components that can respond to external and internal stimuli, such as enzymes or fluorochromes, can serve as imaging agents, allowing for monitoring immune responses and treatment efficacy. Created using Microsoft PhotoDraw (version 2.0.0.0822).
FIGURE 3
FIGURE 3
Graphic representation summarizing the key points of nano‐based CRISPR/Cas9 delivery for molecular targeted therapy of cancer. Created using Microsoft PhotoDraw (version 2.0.0.0822).
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