Experimental and Clinical Pharmacology, Department of Translational Research, National Cancer Institute and Center for Molecular Biomedicine - CRO, Aviano, Italy.
Doctoral School in Nanotechnology, University of Trieste, Trieste, Italy.
Curr Med Chem. 2018;25(34):4224-4268. doi: 10.2174/0929867324666170830113755.
The application of nanotechnology in the medical field is called nanomedicine. Nowadays, this new branch of science is a point of interest for many investigators due to the important advances in which we assisted in recent decades, in particular for cancer treatment. Cancer nanomedicine has been applied in different fields such as drug delivery, nanoformulation and nanoanalytical contrast reagents. Nanotechnology may overcome many limitations of conventional approaches by reducing the side effects, increasing tumor drug accumulation and improving the efficacy of drugs. In the last two decades, nanotechnology has rapidly developed, allowing for the incorporation of multiple therapeutics, sensing and targeting agents into nanoparticles (NPs) for developing new nanodevices capable to detect, prevent and treat complex diseases such as cancer.
In this review, we describe the main drug nanoformulations based on different types of organic NPs, the advantages that the new formulations present in comparison with their free drug counterparts and how nanodrugs have improved clinical care. We subdivided them into four main groups: polymeric NPs, liposomes, micelles and exosomes, a small subgroup that has only recently been used in clinical trials.
The application of nanotechnology to pharmaceutical science has allowed us to build up nanosystems based on at least two stage vectors (drug/nanomaterial), which often shown better pharmacokinetics (PK), bioavailability and biodistribution. As a result of these advantages, the nanomaterials accumulate passively in the tumor (due to the enhanced permeability and retention, effect, EPR), thereby decreasing the side effects of free drug. Recently, many new drug formulations have been translated from bench to bedside.
It is important to underline that the translation of nanomedicines from the basic research phase to clinical use in patients is not only expensive and time-consuming, but that it also requires appropriate funding. After many years spent in the design of innovative nanomaterials, it is now the time for the research to take into consideration the biological obstacles that nanodrugs have to overcome. Barriers such as the mononuclear phagocyte system, intratumoral pressure or multidrug resistance are regularly encountered when a cancer patient is treated, especially in the metastatic setting.
纳米技术在医学领域的应用被称为纳米医学。如今，由于我们在最近几十年取得的重要进展，特别是在癌症治疗方面，这个新的科学分支引起了许多研究人员的兴趣。癌症纳米医学已应用于药物输送、纳米制剂和纳米分析对比试剂等多个领域。纳米技术可以通过减少副作用、增加肿瘤药物积累和提高药物疗效来克服传统方法的许多局限性。在过去的二十年中，纳米技术迅速发展，使得多种治疗剂、传感和靶向剂能够被整合到纳米颗粒（NPs）中，从而开发出能够检测、预防和治疗癌症等复杂疾病的新型纳米器件。
在这篇综述中，我们描述了基于不同类型有机 NPs 的主要药物纳米制剂，与游离药物相比，新制剂具有的优势，以及纳米药物如何改善临床护理。我们将它们分为四大类：聚合物 NPs、脂质体、胶束和外泌体，其中一小部分最近才被用于临床试验。
将纳米技术应用于药物科学使我们能够构建基于至少两个阶段载体（药物/纳米材料）的纳米系统，这些载体通常表现出更好的药代动力学（PK）、生物利用度和生物分布。由于这些优势，纳米材料会被动地在肿瘤中积累（由于增强的通透性和保留效应，EPR），从而降低游离药物的副作用。最近，许多新的药物制剂已经从实验室转化为临床应用。
重要的是要强调，将纳米医学从基础研究阶段转化为患者的临床应用不仅昂贵且耗时，而且还需要适当的资金。经过多年对创新纳米材料的设计，现在是研究考虑纳米药物必须克服的生物障碍的时候了。当癌症患者，特别是在转移性环境中接受治疗时，经常会遇到单核吞噬细胞系统、肿瘤内压力或多药耐药等障碍。
