Chen Chaofan, Li Jinlei, Hua Xiaokun, Deng Tingting, Zhang Zhiyun
Department of Anorectal, Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, Yunnan, China.
Department of Orthopedics, Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, Yunnan, China.
Front Immunol. 2025 Aug 14;16:1653829. doi: 10.3389/fimmu.2025.1653829. eCollection 2025.
Gastrointestinal (GI) cancers remain a leading cause of global cancer morbidity and mortality, demanding novel therapeutic strategies that overcome existing limitations. Nanomedicine has recently emerged as a transformative approach, offering the potential to significantly enhance immunotherapy outcomes through precision targeting and modulation of tumour immune microenvironments. This review discusses the principal categories of precision-engineered nanoparticles-including lipid-based carriers, polymeric systems, protein-derived formulations, and metallic-hybrid composites-emphasising their capacity for targeted immune modulation and improved pharmacokinetic profiles. These nanoparticle platforms strategically intervene across multiple stages of the cancer-immunity cycle, facilitating antigen presentation, T-cell activation, and cytotoxic lymphocyte infiltration, and augmenting immune checkpoint blockade efficacy. Clinically approved nanoformulations such as Abraxane, Doxil, Onivyde, and emerging mRNA-based nanovaccines highlight promising translational outcomes in GI malignancies, demonstrating improved therapeutic indices and reduced systemic toxicity. Nonetheless, clinical implementation remains challenged by nanoparticle complexity, heterogeneous tumour biology, clearance mechanisms, and toxicity concerns. Future success will depend on integrated strategies combining advanced nanoparticle engineering, precise administration routes, rigorous translational validation, and rational therapeutic combinations to realise the full potential of nanomedicine-based immunotherapies in gastrointestinal oncology.
胃肠道(GI)癌症仍然是全球癌症发病率和死亡率的主要原因,需要克服现有局限性的新型治疗策略。纳米医学最近已成为一种变革性方法,有潜力通过精确靶向和调节肿瘤免疫微环境显著提高免疫治疗效果。本综述讨论了精确工程纳米颗粒的主要类别,包括脂质载体、聚合物系统、蛋白质衍生制剂和金属混合复合材料,强调了它们在靶向免疫调节和改善药代动力学方面的能力。这些纳米颗粒平台在癌症免疫循环的多个阶段进行策略性干预,促进抗原呈递、T细胞活化和细胞毒性淋巴细胞浸润,并增强免疫检查点阻断疗效。临床批准的纳米制剂,如白蛋白结合型紫杉醇、多柔比星脂质体、伊立替康脂质体,以及新兴的基于mRNA的纳米疫苗,在胃肠道恶性肿瘤中显示出有前景的转化成果,证明了治疗指数的提高和全身毒性的降低。尽管如此,纳米颗粒的复杂性、肿瘤生物学的异质性、清除机制和毒性问题仍然给临床应用带来挑战。未来的成功将取决于综合策略,结合先进的纳米颗粒工程、精确的给药途径、严格的转化验证和合理的治疗组合,以实现基于纳米医学的免疫疗法在胃肠道肿瘤学中的全部潜力。