Department of Pharmaceutical Sciences, School of Pharmacy, Northeastern University, Boston, MA 02115, USA.
Curr Med Chem. 2012;19(19):3230-40. doi: 10.2174/092986712800784685.
Current challenges in early detection, limitations of conventional treatment options, and the constant evolution of cancer cells with metastatic and multi-drug resistant phenotypes require novel strategies to effectively combat this deadly disease. Nanomedical technologies are evolving at a rapid pace and are poised to play a vital role in diagnostic and therapeutic interventions - the so-called "theranostics" - with potential to advance personalized medicine. In this regard, nanoparticulate delivery systems can be designed with tumor seeking characteristics by utilizing the inherent abnormalities and leaky vasculature of solid tumors or custom engineered with targeting ligands for more specific tumor drug targeting. In this review we discuss some of the recent advances made in the development of multifunctional polymeric nanosystems with an emphasis on image-guided drug and gene delivery. Multifunctional nanosystems incorporate variety of payloads (anticancer drugs and genes), imaging agents (optical probes, radio-ligands, and contrast agents), and targeting ligands (antibodies and peptides) for multi-pronged cancer intervention with potential to report therapeutic outcomes. Through advances in combinatorial polymer synthesis and high-throughput testing methods, rapid progress in novel optical/radiolabeling strategies, and the technological breakthroughs in instrumentation, such as hybrid molecular and functional imaging systems, there is tremendous future potential in clinical utility of theranostic nanosystems.
当前，早期检测面临挑战，传统治疗方案存在局限性，且癌细胞不断进化具有转移和多药耐药表型，这都需要新的策略来有效对抗这种致命疾病。纳米医学技术发展迅速，有望在诊断和治疗干预（即所谓的“治疗学”）中发挥重要作用，具有推进个性化医疗的潜力。在这方面，可以通过利用实体瘤固有的异常和渗漏血管系统，设计具有肿瘤靶向特性的纳米颗粒递药系统，或者通过定制靶向配体，实现更具特异性的肿瘤药物靶向。在这篇综述中，我们讨论了一些最近在多功能聚合物纳米系统开发方面取得的进展，重点是图像引导的药物和基因递药。多功能纳米系统整合了多种有效载荷（抗癌药物和基因）、成像剂（光学探针、放射性配体和对比剂）和靶向配体（抗体和肽），用于多管齐下的癌症干预，具有报告治疗效果的潜力。通过组合聚合物合成和高通量测试方法的进步、新型光学/放射性标记策略的快速发展以及仪器技术的突破，如混合分子和功能成像系统，治疗学纳米系统具有巨大的临床应用潜力。
