JHU ICMIC Program, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
NMR Biomed. 2011 Jul;24(6):636-47. doi: 10.1002/nbm.1664. Epub 2011 Jan 28.
The integration of chemistry and molecular biology with imaging is providing some of the most exciting opportunities in the treatment of cancer. The field of theranostic imaging, where diagnosis is combined with therapy, is particularly suitable for a disease as complex as cancer, especially now that genomic and proteomic profiling can provide an extensive 'fingerprint' of each tumor. Using this information, theranostic agents can be shaped for personalized treatment to target specific compartments, such as the tumor microenvironment (TME), whilst minimizing damage to normal tissue. These theranostic agents can also be used to target multiple pathways or networks by incorporating multiple small interfering RNAs (siRNAs) within a single agent. A decade ago genetic alterations were the primary focus in cancer research. Now it is apparent that the tumor physiological microenvironment, interactions between cancer cells and stromal cells, such as endothelial cells, fibroblasts and macrophages, the extracellular matrix (ECM), and a host of secreted factors and cytokines, influence progression to metastatic disease, aggressiveness and the response of the disease to treatment. In this review, we outline some of the characteristics of the TME, describe the theranostic agents currently available to target the TME and discuss the unique opportunities the TME provides for the design of novel theranostic agents for cancer therapy.
化学和分子生物学与影像学的融合为癌症治疗带来了一些最令人兴奋的机会。治疗诊断一体化领域特别适合治疗像癌症这样复杂的疾病，尤其是现在基因组和蛋白质组分析可以为每个肿瘤提供广泛的“指纹”。利用这些信息，治疗诊断试剂可以针对特定部位（如肿瘤微环境，TME）进行个性化治疗，同时最大限度地减少对正常组织的损伤。这些治疗诊断试剂还可以通过在单个试剂中包含多个小干扰 RNA（siRNA）来靶向多个途径或网络。十年前，基因改变是癌症研究的主要关注点。现在很明显，肿瘤生理微环境、癌细胞与内皮细胞、成纤维细胞和巨噬细胞等基质细胞之间的相互作用、细胞外基质（ECM）以及大量分泌因子和细胞因子，都会影响疾病进展为转移性疾病、侵袭性以及疾病对治疗的反应。在这篇综述中，我们概述了 TME 的一些特征，描述了目前可用于靶向 TME 的治疗诊断试剂，并讨论了 TME 为癌症治疗的新型治疗诊断试剂设计提供的独特机会。
