Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates.
Division of Molecular Therapeutics and Formulation, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK.
Int J Mol Sci. 2022 Feb 6;23(3):1853. doi: 10.3390/ijms23031853.
Lung cancer (LC) is one of the leading causes of cancer occurrence and mortality worldwide. Treatment of patients with advanced and metastatic LC presents a significant challenge, as malignant cells use different mechanisms to resist chemotherapy. Drug resistance (DR) is a complex process that occurs due to a variety of genetic and acquired factors. Identifying the mechanisms underlying DR in LC patients and possible therapeutic alternatives for more efficient therapy is a central goal of LC research. Advances in nanotechnology resulted in the development of targeted and multifunctional nanoscale drug constructs. The possible modulation of the components of nanomedicine, their surface functionalization, and the encapsulation of various active therapeutics provide promising tools to bypass crucial biological barriers. These attributes enhance the delivery of multiple therapeutic agents directly to the tumor microenvironment (TME), resulting in reversal of LC resistance to anticancer treatment. This review provides a broad framework for understanding the different molecular mechanisms of DR in lung cancer, presents novel nanomedicine therapeutics aimed at improving the efficacy of treatment of various forms of resistant LC; outlines current challenges in using nanotechnology for reversing DR; and discusses the future directions for the clinical application of nanomedicine in the management of LC resistance.
肺癌 (LC) 是全球癌症发生和死亡的主要原因之一。治疗晚期和转移性 LC 患者是一个重大挑战，因为恶性细胞使用不同的机制来抵抗化疗。耐药性 (DR) 是一个复杂的过程，由多种遗传和获得性因素引起。确定 LC 患者 DR 的机制以及可能的治疗替代方案以实现更有效的治疗是 LC 研究的核心目标。纳米技术的进步导致了靶向和多功能纳米级药物构建体的发展。纳米医学成分的可能调节、表面功能化以及各种活性治疗药物的封装提供了有前途的工具，可以绕过关键的生物学障碍。这些属性增强了多种治疗药物直接递送到肿瘤微环境 (TME) 的能力，从而逆转了 LC 对抗癌治疗的耐药性。本综述提供了一个广泛的框架来理解肺癌中 DR 的不同分子机制，提出了旨在提高各种形式耐药性 LC 治疗效果的新型纳米医学治疗方法；概述了当前在利用纳米技术逆转 DR 方面面临的挑战；并讨论了纳米医学在管理 LC 耐药性中的临床应用的未来方向。
