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非持续纳米结构增强 HPV+头颈部癌免疫活性原位模型的同期放化疗。

Nonpersistent Nanoarchitectures Enhance Concurrent Chemoradiotherapy in an Immunocompetent Orthotopic Model of HPV+ Head/Neck Carcinoma.

机构信息

Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, Pisa, 56127, Italy.

Radiation Oncology Unit, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Via Roma 67, Pisa, 56126, Italy.

出版信息

Adv Mater. 2024 Jul;36(28):e2400949. doi: 10.1002/adma.202400949. Epub 2024 May 27.

Abstract

Cisplatin chemoradiotherapy (CRT) is the established standard of care for managing locally advanced human papillomavirus-positive head/neck carcinoma. The typically young patients may suffer serious and long-time side effects caused by the treatment, such as dysphagia, and hearing loss. Thus, ensuring a satisfactory post-treatment quality of life is paramount. One potential replacing approach to the classical CRT involves the combination of standard-dose radiotherapy and radiosensitizers such as noble metal nanoparticles (NPs). However, several concerns about size, shape, and biocompatibility limit the translation of metal nanomaterials to the clinical practice. Here, it is demonstrated that a new model of nonpersistent gold nanoarchitectures containing cisplatin (NAs-Cluster-CisPt) generates, in combination with radiotherapy, a significant in vivo tumor-reducing effect compared to the standard CRT, achieving a complete tumor clearance in 25% of the immunocompetent models that persist for 60 days. These findings, together with the negligible amount of metals recognized in the excretory organs, highlight that the concurrent administration of NAs-Cluster-CisPt and radiotherapy has the potential to overcome some clinical limitations associated to NP-based approaches while enhancing the treatment outcome with respect to standard CRT. Overall, despite further mechanistic investigations being essential, these data support the exploiting of nonpersistent metal-nanomaterial-mediated approaches for oral cancer management.

摘要

顺铂放化疗(CRT)是治疗局部晚期人乳头瘤病毒阳性头颈部癌的标准治疗方法。这些通常较为年轻的患者可能会因治疗而遭受严重且长期的副作用,例如吞咽困难和听力损失。因此,确保治疗后的生活质量令人满意至关重要。一种有潜力替代经典 CRT 的方法是将标准剂量的放疗与放射增敏剂(如贵金属纳米颗粒(NPs))结合使用。然而,尺寸、形状和生物相容性等方面的几个问题限制了金属纳米材料在临床实践中的转化。在这里,研究表明,含有顺铂的新型非持久性金纳米结构(NAs-Cluster-CisPt)模型与放疗联合使用,与标准 CRT 相比,在体内具有显著的肿瘤减少效果,在 60 天内,25%的免疫功能正常的模型完全清除了肿瘤。这些发现,以及在排泄器官中检测到的痕量金属,突出表明同时给予 NAs-Cluster-CisPt 和放疗有可能克服与基于 NP 的方法相关的一些临床限制,同时提高相对于标准 CRT 的治疗效果。总的来说,尽管进一步的机制研究是必要的,但这些数据支持利用非持久性金属纳米材料介导的方法来管理口腔癌。

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