Bone metastasis occurs in about 70% of breast cancer patients. The surgical resection of metastatic tumors often leads to bone erosion and destruction, which greatly hinders the treatment and prognosis of breast cancer patients with bone metastasis. Herein, a bifunctional scaffold 3D‐printed from nanoink is fabricated to simultaneously eliminate the tumor cells and repair the tumor‐associated bone defects. The metallic polydopamine (PDA) nanoparticles (FeMg‐NPs) may effectively load and sustainably release the metal ions Fe3+ and Mg2+ in situ. Fe3+ exerts a chemodynamic therapy to synergize with the photothermal therapy induced by PDA with effective photothermal conversion under NIR laser, which efficiently eliminates the bone‐metastatic tumor. Meanwhile, the sustained release of osteoinductive Mg2+ from the bony porous 3D scaffold enhances the new bone formation in the bone defects. Taken together, the implantation of scaffold (FeMg‐SC) 3D‐printed from the FeMg‐NPs‐containing nanoink provides a novel strategy to simultaneously eradicate bone‐metastatic tumor and repair the tumor‐associated bone defects.

The tumor microenvironment (TME) is a very cunning system that enables tumor cells to escape death post‐traditional antitumor treatments through the comprehensive effect of different factors, thereby leading to drug resistance. Deep insights into TME characteristics and tumor resistance encourage the construction of nanomedicines that can remodel the TME against drug resistance. Tremendous interest in combining TME‐regulation measurement with traditional tumor treatment to fight multidrug‐resistant tumors has been inspired by the increasing understanding of the role of TME reconstruction in improving the antitumor efficiency of drug‐resistant tumor therapy. This review focuses on the underlying relationships between specific TME characteristics (such as hypoxia, acidity, immunity, microorganisms, and metabolism) and drug resistance in tumor treatments. The exciting antitumor activities strengthened by TME regulation are also discussed in‐depth, providing solutions from the perspective of nanomedicine design. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Nanotechnology Approaches to Biology > Nanoscale Systems in Biology

Rationale The use of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is currently recommended for staging non‐small cell lung cancer (NSCLC) in centrally located tumors, tumors >3 cm, or with radiologic evidence of lymph node (LN) metastasis. Current guidelines do not recommend staging EBUS‐TBNA in patients with stage I NSCLC who do not have any of the aforementioned conditions. Objective We hypothesize that using EBUS‐TBNA is useful for detecting occult metastasis in radiologic stage I NSCLC. Methods In this single‐center, retrospective study, charts of patients ≥18 years old who underwent staging EBUS‐TBNA from January 2005 to May 2019 were reviewed. Only patients with combined positron‐emission tomography and computed tomography (PET/CT) scans consistent with radiologic stage I NSCLC were included. Identified variables included: age, gender, personal history of any cancer, smoking history, tumor location, tumor centrality, tumor size, tumor PET activity, histopathologic type of NSCLC, and LN biopsy results. Patients whose LN samples showed a diagnosis other than NSCLC were excluded. The association between LN positivity, and each of the variables was assessed using Pearson's correlation for categorical variables, and logistic regression analysis for continuous variables. Results From the 2,892 initially screened patients, 188 were included. Of those, 13 (6.9%; 95% CI, 4%–11%) had a malignancy‐positive LN biopsy. The number needed to test (NNT) in order to detect one case of any occult metastasis was 15. Among the included variables, a significant association was found between LN positivity and tumor centrality, with central tumors found in 61.5% of patients with positive LN (n = 8) (p < 0.01). This association stayed significant after adjusting for age, gender, smoking history, tumor size, tumor location, and PET activity (p = 0.015). Among patients with malignancy‐positive LN biopsies, five (38.5%; 95% CI, 17.6%–64.6%) were upstaged to N1, and eight (61.5%; 95% CI, 35.4%–82.4%) were upstaged to N2, with NNT of 23 to detect one case of occult N2 metastasis. Subgroup analysis comparing LN‐positive patients based on their N stage did not show statistically significant association with any of the variables. Conclusion Based on our results and along with the existing evidence, EBUS‐TBNA should be recommended as part of the routine staging in all patients with radiologic stage I NSCLC.