Department Medical Laboratory Sciences, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Biotechnology, Iranian Research Organization for Science & Technology (IROST), Tehran, Iran.
Department of Hematology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
Life Sci. 2024 Nov 1;356:122989. doi: 10.1016/j.lfs.2024.122989. Epub 2024 Aug 27.
Multiple myeloma, the second most common hematological malignancy, remains incurable with a 5-year survival rate of approximately 50 % and recurrence rates near 100 %, despite significant attempts to develop effective medicines. Therefore, there is a pressing demand in the medical field for innovative and more efficient treatments for MM. Currently, the standard approach for treating MM involves administering high-dose chemotherapy, which frequently correlates with improved results; however, one major limiting factor is the significant side effects of these medications. Furthermore, the strategies used to deliver medications to tumors limit their efficacy, whether by rapid clearance from circulation or an insufficient concentration in cancer cells. Cancer treatment has shifted from cytotoxic, nonspecific chemotherapy regimens to molecularly targeted, rationally developed drugs with improved efficacy and fewer side effects. Nanomedicines may provide an effective alternative way to avoid these limits by delivering drugs into the complicated bone marrow microenvironment and efficiently reaching myeloma cells. Putting drugs into nanoparticles can make their pharmacokinetic and pharmacodynamic profiles much better. This can increase the drug's effectiveness in tumors, extend its time in circulation in the blood, and lower its off-target toxicity. In this review, we introduce several criteria for the rational design of nanomedicine to achieve the best anti-tumoral therapeutic results. Next, we discuss recent advances in nanomedicine for MM therapy.
多发性骨髓瘤是第二大常见的血液系统恶性肿瘤,尽管人们曾尝试开发有效的药物,但目前仍无法治愈,其 5 年生存率约为 50%,复发率接近 100%。因此,医学界迫切需要创新且更有效的 MM 治疗方法。目前,治疗 MM 的标准方法是采用大剂量化疗,这通常会带来更好的效果;但一个主要的限制因素是这些药物有严重的副作用。此外,用于向肿瘤输送药物的策略限制了其疗效,无论是由于药物在循环中迅速清除还是由于癌细胞中药物浓度不足。癌症治疗已经从细胞毒性、非特异性化疗方案转向了具有更好疗效和更少副作用的分子靶向、合理开发的药物。纳米医学可能通过将药物递送到复杂的骨髓微环境中并有效地到达骨髓瘤细胞,提供一种避免这些限制的有效方法。将药物装入纳米颗粒可以使其药代动力学和药效学特性得到极大改善。这可以提高药物在肿瘤中的疗效,延长其在血液中的循环时间,并降低其脱靶毒性。在这篇综述中,我们介绍了纳米医学的合理设计的几个标准,以达到最佳的抗肿瘤治疗效果。接下来,我们讨论了纳米医学在 MM 治疗中的最新进展。