Martinelli Chiara, Biglietti Marco
Independent Researcher, Como 22100, Italy.
Independent Researcher, Milan 20148, Italy.
Cancer Drug Resist. 2020 Oct 12;3(4):1003-1020. doi: 10.20517/cdr.2020.47. eCollection 2020.
Every year, cancer accounts for a vast portion of deaths worldwide. Established clinical protocols are based on chemotherapy, which, however, is not tumor-selective and produces a series of unbearable side effects in healthy tissues. As a consequence, multidrug resistance (MDR) can arise causing metastatic progression and disease relapse. Combination therapy has demonstrated limited responses in the treatment of MDR, mainly due to the different pharmacokinetic properties of administered drugs and to tumor heterogeneity, challenges that still need to be solved in a significant percentage of cancer patients. In this perspective, we briefly discuss the most relevant MDR mechanisms leading to therapy failure and we report the most advanced strategies adopted in the nanomedicine field for the design and evaluation of nanocarriers. We present some emerging classes of nanocarriers developed to reverse MDR and discuss recent progress evidencing their limits and promises.
每年，癌症在全球死亡原因中占很大比例。既定的临床方案以化疗为基础，然而，化疗并非肿瘤选择性的，会在健康组织中产生一系列难以忍受的副作用。因此，可能会出现多药耐药（MDR），导致转移进展和疾病复发。联合疗法在治疗MDR方面显示出有限的疗效，主要是由于所用药物不同的药代动力学特性以及肿瘤异质性，在相当比例的癌症患者中，这些挑战仍有待解决。从这个角度来看，我们简要讨论导致治疗失败的最相关的MDR机制，并报告纳米医学领域在纳米载体设计和评估中采用的最先进策略。我们介绍了一些为逆转MDR而开发的新兴纳米载体类别，并讨论了近期进展，证明了它们的局限性和前景。
