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纳米医学在结直肠癌系统治疗中的应用研究进展。

Research advances in nanomedicine applied to the systemic treatment of colorectal cancer.

机构信息

Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China.

出版信息

Int J Cancer. 2023 Mar 1;152(5):807-821. doi: 10.1002/ijc.34256. Epub 2022 Sep 8.

DOI:10.1002/ijc.34256
PMID:35984398
Abstract

The systematic treatment of colorectal cancer (CRC) still has room for improvement. The efficacy of chemotherapy, that of anti-vascular therapy, and that of immunotherapy have been unsatisfactory. In recent years, nanomaterials have been used as carriers to improve the bioavailability of anticancer drugs. For the treatment of colorectal cancer, nanodrugs increase the possibility of more precise targeted delivery. However, the actual benefits may cover more aspects. Nanocarriers can produce synergistic effects with anticancer drugs, including the scavenging of reactive oxygen species and co-delivery of a variety of drugs. Currently, immunotherapy has very limited clinical applications in CRC. Modified nanocarriers can activate the immune microenvironment, which can be used for staging antigen recognition or the immune response. Cancer vaccines based on nanomaterials and modified immune checkpoint inhibitors have shown therapeutic potential in animal models. Considering the direct or indirect relationship between the intestinal microflora and CRC, a variety of nanodrugs that regulate microbial function have been explored as an anticancer strategy, and the special structure of microorganisms can also be used as a basis for improving the delivery of traditional nanoparticles (NPs). This review summarizes recent research performed on nanocarriers in in vivo and in vitro models and the synergistic anticancer effects of nanocarriers, focusing on the interaction between NPs and the body, resulting in enhanced efficacy and immune activation. Furthermore, this review describes the current trend of NPs used in the treatment of CRC.

摘要

结直肠癌(CRC)的系统治疗仍有改进空间。化疗、抗血管治疗和免疫治疗的疗效均不理想。近年来,纳米材料已被用作载体,以提高抗癌药物的生物利用度。对于结直肠癌的治疗,纳米药物增加了更精确靶向递送的可能性。然而,实际的益处可能涵盖更多方面。纳米载体可以与抗癌药物产生协同作用,包括清除活性氧和共递多种药物。目前,免疫疗法在 CRC 中的临床应用非常有限。改良的纳米载体可以激活免疫微环境,用于分期抗原识别或免疫反应。基于纳米材料的癌症疫苗和改良的免疫检查点抑制剂在动物模型中显示出治疗潜力。考虑到肠道微生物群与 CRC 之间的直接或间接关系,已经探索了多种调节微生物功能的纳米药物作为抗癌策略,而微生物的特殊结构也可以作为改进传统纳米颗粒(NPs)递送的基础。本文综述了纳米载体在体内和体外模型中的最新研究进展以及纳米载体的协同抗癌作用,重点介绍了 NPs 与机体的相互作用,从而增强了疗效和免疫激活。此外,本文还描述了 NPs 在 CRC 治疗中的当前趋势。

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