Jefremow André, Neurath Markus F
Department of Internal Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Visc Med. 2020 Apr;36(2):88-94. doi: 10.1159/000506908. Epub 2020 Mar 18.
Gastrointestinal malignancies have the greatest incidence and cancer-associated death rates worldwide. Routine therapeutic modalities include surgery, chemotherapy and radiation but they often fail to reach the goal of cancer-free survival.
In the light of this urgent medical need for the treatment of GI tumors, nanotech-nology-based approaches, i.e. nanomedicine, promise new therapeutic options. Using nanoparticles instead of classically designed drugs, targeting anticancer agents directly to the tumor site may revolutionize both diagnostic and therapeutic tools thereby facilitating the identification and elimination of malignant cells. Importantly, diagnostic insight and therapeutic effects can be achieved simultaneously through the same nanoparticle. Additionally, a nanoparticle may be loaded with more than one agent, thereby further increasing the value and power of the nanotechnology approach in oncologic therapeutic concepts. Although most insight into mechanisms of nanomedicine has been gained from in vitro and preclinical in vivo models, few clinical trials have been conducted, and nanomedicine-based concepts are already part of standard treatment algorithms. However, despite substantial progress it remains a challenge to design nanoparticles that feature all desirable characteristics at the same time.
This review seeks to provide substantial insight into the current status of nanomedicine-based approaches employed for diagnostic and/or therapeutic purposes in the field of gastrointestinal cancers by highlighting achievements and pointing out unresolved issues that need to be further addressed by future research attempts.
胃肠道恶性肿瘤在全球范围内发病率和癌症相关死亡率最高。常规治疗方式包括手术、化疗和放疗,但这些方法往往无法实现无癌生存的目标。
鉴于治疗胃肠道肿瘤的迫切医疗需求,基于纳米技术的方法,即纳米医学,有望提供新的治疗选择。使用纳米颗粒而非传统设计的药物,将抗癌药物直接靶向肿瘤部位,可能会彻底改变诊断和治疗工具,从而有助于识别和消除恶性细胞。重要的是,通过同一纳米颗粒可同时实现诊断洞察和治疗效果。此外,一个纳米颗粒可负载不止一种药物,从而进一步提高纳米技术方法在肿瘤治疗概念中的价值和效能。尽管对纳米医学机制的大多数认识来自体外和临床前体内模型,但开展的临床试验较少,且基于纳米医学的概念已成为标准治疗方案的一部分。然而,尽管取得了重大进展,但设计同时具备所有理想特性的纳米颗粒仍然是一项挑战。
本综述旨在通过突出成就并指出未来研究需要进一步解决的未决问题,深入了解基于纳米医学的方法在胃肠道癌症领域用于诊断和/或治疗目的的现状。