Yu Mengzhen, Zhang Yanwen, Fang Meirong, Jehan Shah, Zhou Wenhu
Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
Pharmaceutics. 2022 Mar 30;14(4):743. doi: 10.3390/pharmaceutics14040743.
Arsenic trioxide (ATO) is one of the first-line chemotherapeutic drugs for acute promyelocytic leukemia. Its anti-cancer activities against various human neoplastic diseases have been extensively studied. However, the clinical use of ATO for solid tumors is limited, and these limitations are because of severe systemic toxicity, low bioavailability, and quick renal elimination before it reaches the target site. Although without much success, several efforts have been made to boost ATO bioavailability toward solid tumors without raising its dose. It has been found that nanomedicines have various advantages for drug delivery, including increased bioavailability, effectiveness, dose-response, targeting capabilities, and safety as compared to traditional drugs. Therefore, nanotechnology to deliver ATO to solid tumors is the main topic of this review, which outlines the previous and present medical applications of ATO. We also summarised ATO anti-cancer mechanisms, limitations, and outcomes of combinatorial treatment with chemo agents. As a result, we strongly recommend conducting pre-clinical and clinical studies of ATO, especially nano-system-based ones that might lead to a novel combination therapy for cancer treatment with high efficacy, bioavailability, and low toxicity for cancer patients.
三氧化二砷（ATO）是急性早幼粒细胞白血病的一线化疗药物之一。其对各种人类肿瘤疾病的抗癌活性已得到广泛研究。然而，ATO在实体瘤临床应用方面存在局限性，这些局限性是由于严重的全身毒性、低生物利用度以及在到达靶位点之前快速经肾清除。尽管成效不大，但人们已做出多项努力，在不增加ATO剂量的情况下提高其对实体瘤的生物利用度。已发现纳米药物在药物递送方面具有多种优势，与传统药物相比，包括提高生物利用度、有效性、剂量反应、靶向能力和安全性。因此，将ATO递送至实体瘤的纳米技术是本综述的主题，该综述概述了ATO以往和目前的医学应用。我们还总结了ATO的抗癌机制、局限性以及与化疗药物联合治疗的结果。因此，我们强烈建议开展ATO的临床前和临床研究，尤其是基于纳米系统的研究，这可能会带来一种对癌症患者具有高疗效、高生物利用度和低毒性的新型联合癌症治疗方法。
