Application of nanotechnology in the diagnosis and treatment of bladder cancer

Abstract

Bladder cancer (BC) is a common malignancy in the genitourinary system and the current theranostic approaches are unsatisfactory. Sensitivity and specificity of current diagnosis methods are not ideal and high recurrence and progression rates after initial treatment indicate the urgent need for management improvements in clinic. Nanotechnology has been proposed as an effective method to improve theranosis efficiency for both non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC). For example, gold nanoparticles (AuNPs) have been developed for simple, fast and sensitive urinary sample test for bladder cancer diagnosis. Nanoparticles targeting bladder cancers can facilitate to distinguish the normal and abnormal bladder tissues during cystoscopy and thus help with the complete removal of malignant lesions. Both intravenous and intravesical agents can be modified by nanotechnology for targeted delivery, high anti-tumor efficiency and excellent tolerability, exhibiting encouraging potential in bladder cancer treatment. Photosensitizers and biological agents can also be delivered by nanotechnology, intermediating phototherapy and targeted therapy. The management of bladder cancer remained almost unchanged for decades with unsatisfactory effect. However, it is likely to change with the fast-developed nanotechnology. Herein we summarized the current utility of nanotechnology in bladder cancer diagnosis and treatment, providing insights for the future designing and discovering novel nanoparticles for bladder cancer management. Graphical Abstract

Effect of Radical Laparoscopic Surgery and Conventional Open Surgery on Surgical Outcomes, Complications, and Prognosis in Elderly Patients with Bladder Cancer

“…Open radical cystectomy is the standard method for treating patients with bladder cancer, and its therapeutic effects are universally recognized, but the surgical procedure is significantly traumatic for the patient and not only the amount of bleeding but also the postoperative complications adversely affect the patient's recovery [ 13 ]. Therefore, patients need a longer period of time to recover after the completion of the surgery, coupled with the degeneration of physiological organ functions, decreased immunity, and more underlying diseases in elderly patients, who have relatively low tolerance for open surgery [ 14 ].…”

Traditional Chinese medicine active ingredients-based selenium nanoparticles regulate antioxidant selenoproteins for spinal cord injury treatment

“…Hence, it is urgent to explore a novel approach to conquer above problems to maximize the antioxidant effect of APS and TSIIA. Nanotechnology has been considered to be an effective method to improve the effectiveness of the existing drugs [ 18 – 22 ].…”

Iron oxide@chlorophyll clustered nanoparticles eliminate bladder cancer by photodynamic immunotherapy-initiated ferroptosis and immunostimulation

“…Unfortunately, programmed death-ligand 1, a coinhibitory factor of the immune response, is highly expressed in BC, resulting in an immunosuppressive “cold tumor” environment that diminishes immunotherapy efficacy [ 5 ]. In summary, the limitation of treatment options and elevation of recurrence potential are due to restricted immune cell infiltration, poor response to chemotherapy, and the adverse effects of long-term treatment [ 3 , 6 ]. Therefore, designing a multitarget treatment strategy could provide new insights into eradicating BC progression.…”

“…Inspired by the transurethral BCG treatment process, in which BCG is instilled into the bladder through a catheter, rather than systemic circulation by intravenous injection, we used intravesical instillation of nano-photosensitizers that can interact directly with tumors in the bladder (Scheme 1 ). Our CDT–PDT treatment in BC revealed the first immunostimulatory feature in the irradiated area of light [ 6 , 8 , 36 , 37 ], which reprograms the tumor microenvironment from an immunosuppressive “cold” to an immunogenic “hot” tumor. CDT–PDT treatment may not only suppress the production of immunosuppressive factors and cells but also boost the accumulation of immunostimulatory cells.…”

“…PDT was combined with other endogenous chemical therapeutic strategies to improve treatment efficiency in malignant BC [6,[14][15][16][33][34][35]. For example, O 2 -generating nanoparticles (iron oxide@organoselenium [33] and HSA-MnO 2 -Ce6 [34]) and chemotherapeutic Pt released from iron oxide/Pt hybrid NPs [35] can exert some effect on bladder tumors when the therapeutic outcome is not satisfactory and can even promote PDT-induced cytotoxicity and antitumor immunity.…”