Dasari Nagasen, Guntuku Girija Sankar, Pindiprolu Sai Kiran S S
Andhra University College of Pharmaceutical Sciences, Andhra University, Vishakhapatnam, Andhra Pradesh, India.
Aditya Pharmacy College, Surampalem, Andhra Pradesh, India.
Discov Nano. 2024 Mar 7;19(1):41. doi: 10.1186/s11671-024-03985-y.
Breast cancer is a complex and heterogeneous disease, encompassing various subtypes characterized by distinct molecular features, clinical behaviors, and treatment responses. Categorization of subtypes is based on the presence or absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), leading to subtypes such as luminal A, luminal B, HER2-positive, and triple-negative breast cancer (TNBC). TNBC, comprising around 20% of all breast cancers, lacks expression of ER, PR, and HER2 receptors, rendering it unresponsive to targeted therapies and presenting significant challenges in treatment. TNBC is associated with aggressive behavior, high rates of recurrence, and resistance to chemotherapy. Tumor initiation, progression, and treatment resistance in TNBC are attributed to breast cancer stem cells (BCSCs), which possess self-renewal, differentiation, and tumorigenic potential. Surface markers, self-renewal pathways (Notch, Wnt, Hedgehog signaling), apoptotic protein (Bcl-2), angiogenesis inhibition (VEGF inhibitors), and immune modulation (cytokines, immune checkpoint inhibitors) are among the key targets discussed in this review. However, targeting the BCSC subpopulation in TNBC presents challenges, including off-target effects, low solubility, and bioavailability of anti-BCSC agents. Nanoparticle-based therapies offer a promising approach to target various molecular pathways and cellular processes implicated in survival of BSCS in TNBC. In this review, we explore various nanocarrier-based approaches for targeting BCSCs in TNBC, aiming to overcome these challenges and improve treatment outcomes for TNBC patients. These nanoparticle-based therapeutic strategies hold promise for addressing the therapeutic gap in TNBC treatment by delivering targeted therapies to BCSCs while minimizing systemic toxicity and enhancing treatment efficacy.
乳腺癌是一种复杂的异质性疾病,包含多种具有不同分子特征、临床行为和治疗反应的亚型。亚型分类基于雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER2)的有无,从而产生诸如腔面A型、腔面B型、HER2阳性和三阴性乳腺癌(TNBC)等亚型。TNBC约占所有乳腺癌的20%,缺乏ER、PR和HER2受体的表达,使其对靶向治疗无反应,并在治疗中带来重大挑战。TNBC与侵袭性生物学行为、高复发率和化疗耐药相关。TNBC中的肿瘤起始、进展和治疗耐药归因于乳腺癌干细胞(BCSC),其具有自我更新、分化和致瘤潜力。表面标志物、自我更新途径(Notch、Wnt、Hedgehog信号通路)、凋亡蛋白(Bcl-2)、血管生成抑制(VEGF抑制剂)和免疫调节(细胞因子、免疫检查点抑制剂)是本综述中讨论的关键靶点。然而,靶向TNBC中的BCSC亚群存在挑战,包括脱靶效应、抗BCSC药物的低溶解度和生物利用度。基于纳米颗粒的疗法为靶向TNBC中与BCSC存活相关的各种分子途径和细胞过程提供了一种有前景的方法。在本综述中,我们探讨了针对TNBC中BCSC的各种基于纳米载体的方法,旨在克服这些挑战并改善TNBC患者的治疗结果。这些基于纳米颗粒的治疗策略有望通过将靶向治疗递送至BCSC,同时最小化全身毒性并提高治疗效果,来解决TNBC治疗中的治疗差距。
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