School of Preclinical Medicine, Chengdu University, Chengdu 610106, China.
National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, China.
J Control Release. 2023 Oct;362:548-564. doi: 10.1016/j.jconrel.2023.09.014. Epub 2023 Sep 9.
Colorectal cancer (CRC), one of the most common and deadliest diseases worldwide, poses a great health threat and social burden. The clinical treatments of CRC encompassing surgery, chemotherapy, and radiotherapy are challenged with toxicity, therapy resistance, and recurrence. In the past two decades, targeted therapy and immunotherapy have greatly improved the therapeutic benefits of CRC patients but they still suffer from drug resistance and low response rates. Very recently, gut microbiota regulation has exhibited a great potential in preventing and treating CRC, as well as in modulating the efficacy and toxicity of chemotherapy and immunotherapy. In this review, we provide a cutting-edge summary of nanomedicine-based treatment in colorectal cancer, highlighting the recent progress of oral and systemic tumor-targeting and/or tumor-activatable drug delivery systems as well as novel therapeutic strategies against CRC, including nano-sensitizing immunotherapy, anti-inflammation, gut microbiota modulation therapy, etc. Finally, the recent endeavors to address therapy resistance, metastasis, and recurrence in CRC were discussed. We hope this review could offer insight into the design and development of nanomedicines for CRC and beyond.
结直肠癌(CRC)是全球最常见和最致命的疾病之一,对健康构成了巨大威胁,同时也带来了沉重的社会负担。CRC 的临床治疗方法包括手术、化疗和放疗,但这些方法存在毒性、治疗耐药性和复发等问题。在过去的二十年中,靶向治疗和免疫疗法极大地提高了 CRC 患者的治疗效果,但它们仍然存在耐药性和低反应率的问题。最近,肠道微生物群调节在预防和治疗 CRC 方面显示出巨大的潜力,也可以调节化疗和免疫疗法的疗效和毒性。在这篇综述中,我们提供了基于纳米医学治疗结直肠癌的最新概述,重点介绍了口服和系统肿瘤靶向和/或肿瘤激活药物传递系统以及针对 CRC 的新型治疗策略的最新进展,包括纳米敏化免疫疗法、抗炎、肠道微生物群调节疗法等。最后,讨论了最近在解决 CRC 中的治疗耐药性、转移和复发方面的努力。我们希望这篇综述能够为 CRC 及其它疾病的纳米医学设计和开发提供一些思路。