Sengupta Shiladitya
Division of Engineering in Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA; Dana Farber Cancer Institute, Boston, MA, USA.
Trends Cancer. 2017 Aug;3(8):551-560. doi: 10.1016/j.trecan.2017.06.006. Epub 2017 Jul 23.
Cancer nanotechnology and cancer immunotherapy are two parallel themes that have emerged over the last few decades in the search for a cure for cancer. Exciting applications can emerge at the intersection of these two fields. However, it is important to learn from the past successes and failures of cancer nanomedicines for its future applications in cancer immunotherapy. This review discusses the two key parameters that defined clinical success in the case of cancer nanomedicines: (i) physicochemical design principles, and (ii) clinical trial design, which are frequently overlooked in most analyses of the state of the field. Learning from the design principles that defined success for the clinically-used cancer nanomedicines can enable the design of next-generation nanomedicines that can address some of the emerging challenges in cancer immunotherapy, for example (i) enabling combinations of molecularly targeted therapies with immunotherapies that are pharmacologically incompatible; (ii) early monitoring of efficacy of immunotherapies; and (iii) personalizing an immune response to a patient's tumor. Currently, only a subset of patients treated with immunotherapy exhibit durable response; the integration of nanomedicine and immunotherapy to address the above challenges can lead to new paradigms in the treatment of cancer.
癌症纳米技术和癌症免疫疗法是过去几十年来在寻求癌症治疗方法过程中出现的两个并行主题。这两个领域的交叉点可能会产生令人兴奋的应用。然而，为了癌症纳米药物未来在癌症免疫疗法中的应用，借鉴其过去的成功与失败经验很重要。本综述讨论了在癌症纳米药物案例中定义临床成功的两个关键参数：（i）物理化学设计原则，以及（ii）临床试验设计，而在该领域现状的大多数分析中，这两个参数常常被忽视。借鉴为临床使用的癌症纳米药物定义成功的设计原则，能够设计出下一代纳米药物，以应对癌症免疫疗法中一些新出现的挑战，例如（i）使分子靶向疗法与药理学上不相容的免疫疗法联合使用；（ii）对免疫疗法的疗效进行早期监测；以及（iii）针对患者肿瘤个性化免疫反应。目前，接受免疫疗法治疗的患者中只有一部分表现出持久反应；将纳米医学与免疫疗法相结合以应对上述挑战，可能会带来癌症治疗的新范式。
