Sun Qingxue, Ojha Tarun, Kiessling Fabian, Lammers Twan, Shi Yang
Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic , 52074 Aachen, Germany.
Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht, 3584 CG, The Netherlands.
Biomacromolecules. 2017 May 8;18(5):1449-1459. doi: 10.1021/acs.biomac.7b00068. Epub 2017 Mar 31.
Tumor-targeted nanomedicines have been extensively applied to alter the drawbacks and enhance the efficacy of chemotherapeutics. Despite the large number of preclinical nanomedicine studies showing initial success, their therapeutic benefit in the clinic has been rather modest, which is partially due to the inefficient tumor penetration caused by the tumor microenvironment (high density of cells and extracellular matrix, increased interstitial fluid pressure). Furthermore, tumor penetration of nanomedicines is significantly influenced by physicochemical characteristics, such as size, surface chemistry, and shape. The effect of size on tumor penetration has been exploited to design nanomedicines with switchable size to tackle this challenge. Moreover, several pharmacological and physical approaches have been developed to enhance the tumor penetration of nanomedicines, by penetration-promoting ligands, intratumoral drug release, and modulating the tumor microenvironment and vasculature. Overall, these efforts have resulted in nanomedicines with better tumor penetration properties and with enhanced therapeutic efficacy. Future research should be directed to penetration-promoting strategies with broad applicability and with high translational potential.
肿瘤靶向纳米药物已被广泛应用于改变化疗药物的缺点并提高其疗效。尽管大量临床前纳米药物研究显示出初步成功,但它们在临床上的治疗益处相当有限,部分原因是肿瘤微环境(细胞和细胞外基质密度高、间质液压力增加)导致的肿瘤穿透效率低下。此外,纳米药物的肿瘤穿透性受到物理化学特性的显著影响,如尺寸、表面化学和形状。尺寸对肿瘤穿透的影响已被用于设计具有可切换尺寸的纳米药物来应对这一挑战。此外,还开发了几种药理学和物理方法来增强纳米药物的肿瘤穿透性,通过渗透促进配体、瘤内药物释放以及调节肿瘤微环境和脉管系统。总体而言,这些努力已产生具有更好肿瘤穿透特性和增强治疗效果的纳米药物。未来的研究应致力于具有广泛适用性和高转化潜力的渗透促进策略。