School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, 85287-9709, USA.
Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
Ann Biomed Eng. 2021 Aug;49(8):1943-1972. doi: 10.1007/s10439-020-02704-9. Epub 2021 Jan 5.
The burden of cancer continues to increase in society and negatively impacts the lives of numerous patients. Due to the high cost of current treatment strategies, there is a crucial unmet need to develop inexpensive preclinical platforms to accelerate the process of anti-cancer drug discovery to improve outcomes in cancer patients, most especially in female patients. Many current methods employ expensive animal models which not only present ethical concerns but also do not often accurately predict human physiology and the outcomes of anti-cancer drug responsiveness. Conventional treatment approaches for cancer generally include systemic therapy after a surgical procedure. Although this treatment technique is effective, the outcome is not always positive due to various complex factors such as intratumor heterogeneity and confounding factors within the tumor microenvironment (TME). Patients who develop metastatic disease still have poor prognosis. To that end, recent efforts have attempted to use 3D microengineered platforms to enhance the predictive power and efficacy of anti-cancer drug screening, ultimately to develop personalized therapies. Fascinating features of microengineered assays, such as microfluidics, have led to the advancement in the development of the tumor-on-chip technology platforms, which have shown tremendous potential for meaningful and physiologically relevant anti-cancer drug discovery and screening. Three dimensional microscale models provide unprecedented ability to unveil the biological complexities of cancer and shed light into the mechanism of anti-cancer drug resistance in a timely and resource efficient manner. In this review, we discuss recent advances in the development of microengineered tumor models for anti-cancer drug discovery and screening in female-related cancers. We specifically focus on female-related cancers to draw attention to the various approaches being taken to improve the survival rate of women diagnosed with cancers caused by sex disparities. We also briefly discuss other cancer types like colon adenocarcinomas and glioblastoma due to their high rate of occurrence in females, as well as the high likelihood of sex-biased mutations which complicate current treatment strategies for women. We highlight recent advances in the development of 3D microscale platforms including 3D tumor spheroids, microfluidic platforms as well as bioprinted models, and discuss how they have been utilized to address major challenges in the process of drug discovery, such as chemoresistance, intratumor heterogeneity, drug toxicity, etc. We also present the potential of these platform technologies for use in high-throughput drug screening approaches as a replacements of conventional assays. Within each section, we will provide our perspectives on advantages of the discussed platform technologies.
癌症的负担在社会中不断增加,对众多患者的生活产生了负面影响。由于当前治疗策略的成本高昂,因此迫切需要开发廉价的临床前平台,以加速抗癌药物的发现过程,从而改善癌症患者的治疗效果,尤其是女性患者。目前许多方法都采用昂贵的动物模型,这不仅存在伦理问题,而且往往不能准确预测人体生理学和抗癌药物反应性的结果。癌症的常规治疗方法通常包括手术后的全身治疗。虽然这种治疗技术有效,但由于肿瘤内异质性和肿瘤微环境中的混杂因素等各种复杂因素,结果并不总是乐观。发生转移性疾病的患者预后仍然较差。为此,最近的研究努力尝试使用 3D 微工程平台来提高抗癌药物筛选的预测能力和效果,最终开发个性化治疗方法。微工程检测引人入胜的特点,如微流控技术,推动了肿瘤芯片技术平台的发展,该平台为有意义和生理相关的抗癌药物发现和筛选提供了巨大的潜力。三维微尺度模型提供了前所未有的能力,可以揭示癌症的生物学复杂性,并及时以高效利用资源的方式揭示抗癌药物耐药性的机制。在这篇综述中,我们讨论了用于女性相关癌症的抗癌药物发现和筛选的微工程肿瘤模型的最新进展。我们特别关注女性相关癌症,以引起人们对各种方法的关注,这些方法旨在提高因性别差异而诊断出的癌症患者的生存率。我们还简要讨论了其他癌症类型,如结肠腺癌和胶质母细胞瘤,因为它们在女性中的发病率较高,以及性偏向突变的可能性较高,这使女性的当前治疗策略变得复杂。我们强调了 3D 微尺度平台的最新进展,包括 3D 肿瘤球体、微流控平台以及生物打印模型,并讨论了它们如何被用于解决药物发现过程中的主要挑战,如化疗耐药性、肿瘤内异质性、药物毒性等。我们还介绍了这些平台技术在高通量药物筛选方法中的应用潜力,以替代传统的检测方法。在每个部分中,我们将提供对所讨论平台技术优势的看法。
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