The Institute for Translational Nanomedicine, Shanghai East Hospital, the Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai, 200092, P. R. China.
Department of Oral and Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, P. R. China.
Adv Mater. 2018 Apr;30(17):e1705660. doi: 10.1002/adma.201705660. Epub 2018 Mar 5.
Medical science has recently advanced to the point where diagnosis and therapeutics can be carried out with high precision, even at the molecular level. A new field of "precision medicine" has consequently emerged with specific clinical implications and challenges that can be well-addressed by newly developed nanomaterials. Here, a nanoscience approach to precision medicine is provided, with a focus on cancer therapy, based on a new concept of "molecularly-defined cancers." "Next-generation sequencing" is introduced to identify the oncogene that is responsible for a class of cancers. This new approach is fundamentally different from all conventional cancer therapies that rely on diagnosis of the anatomic origins where the tumors are found. To treat cancers at molecular level, a recently developed "microRNA replacement therapy" is applied, utilizing nanocarriers, in order to regulate the driver oncogene, which is the core of cancer precision therapeutics. Furthermore, the outcome of the nanomediated oncogenic regulation has to be accurately assessed by the genetically characterized, patient-derived xenograft models. Cancer therapy in this fashion is a quintessential example of precision medicine, presenting many challenges to the materials communities with new issues in structural design, surface functionalization, gene/drug storage and delivery, cell targeting, and medical imaging.
医学科学最近已经发展到可以在分子水平上进行高精度的诊断和治疗的地步。因此，出现了一个新的“精准医学”领域，具有特定的临床意义和挑战，这些挑战可以通过新开发的纳米材料很好地解决。在这里，我们提供了一种基于“分子定义癌症”新概念的纳米科学方法来进行精准医学，重点是癌症治疗。“下一代测序”被引入以鉴定导致一类癌症的致癌基因。这种新方法与所有依赖于诊断肿瘤所在解剖起源的传统癌症疗法有根本的不同。为了在分子水平上治疗癌症，最近开发了一种“microRNA 替换疗法”，利用纳米载体来调节驱动致癌基因，这是癌症精准治疗的核心。此外，还必须通过基因特征化的患者来源异种移植模型来准确评估纳米介导的致癌调控的结果。这种癌症治疗是精准医学的一个典型例子，为材料界带来了许多挑战，涉及结构设计、表面功能化、基因/药物储存和输送、细胞靶向和医学成像等新问题。
