Nanomedicine in Chemoradiation

Abstract

Chemoradiotherapy, the concurrent administration of chemotherapy and radiotherapy, is a treatment paradigm in oncology. It is part of the standard of care and curative treatment of many cancers. Given its importance, one of the primary goals of cancer research has been to identify agents and/or strategies that can improve the therapeutic index of chemoradiation. Recent advances in nanomedicine have provided a unique and unprecedented opportunity for improving chemoradiotherapy. Nanoparticles possess properties that are ideally suited for delivering chemotherapy in the chemoradiation setting. The goal of this review is to examine the role of incorporating nanomedicine into chemoradiation and the potential impact of nanomedicine to chemoradiotherapy.

Tumor Radiosensitization by Monomethyl Auristatin E: Mechanism of Action and Targeted Delivery

“…This results in no net gain in the therapeutic index of radiotherapy. Previous reports have tested nanoparticles as radiosensitizer delivery vehicles (24-27). Here, we have demonstrated the efficacy of ACPP technology to deliver the potent radiosensitizer MMAE specifically to tumors.…”

All‐in‐One Theranostic Nanoplatform Based on Hollow TaOx for Chelator‐Free Labeling Imaging, Drug Delivery, and Synergistically Enhanced Radiotherapy

“…Compared with 4T1 cells treated with PBS or plain H‐TaOx‐PEG, the cells treated with H‐TaOx‐PEG@SN‐38 exhibited higher proportions in G1 and G2/M phases and a reduced proportion in S phase, probably due to the predominant S‐phase targeting ability of SN‐38. [5b] Because cancer cells in S phase are more resistant to X‐ray irradiation than any other phases, the ability of H‐TaOx‐PEG@SN‐38 to arrest cell cycles into radiation‐sensitive phases (such as G1 and G2/M phases) can further enhance radiation‐induced cell damage. [5b,c,18a,21,23] Therefore, H‐TaOx‐PEG@SN‐38 is a rather potent agent to enhance RT‐induced DNA damage and cancer cell killing, likely via a comprehensive mechanism with TaOx acting as a radiosensitizer to deposit more radiation energy into cancer cells, and SN‐38 as a cell cycle arresting agent to increase radiation‐sensitivity of cells …”

“…Meanwhile, radioresistances often occurred in many solid tumors during RT, leading to poor RT outcomes and negative prognosis . To overcome those limitations of RT, the combination of chemotherapy with radiotherapy (chemoradiotherapy) represents a potent strategy for comprehensive treatment of malignancies, especially for radioresistant tumors, via increasing amount of DNA damage, inhibiting repair of nonlethal DNA damage, or cell cycle arrest into radiosensitive phases . However, many chemotherapeutic drugs are hydrophobic and have poor pharmacokinetic profiles.…”

Neoantigen activation, Protein Translocation and Targeted Drug Delivery in Combination With Radiotherapy

“…Likewise, Abraxane appears to be safer than standard paclitaxel in women with Phase III breast cancer, as it has reduced toxicity [37,38]. NP products are also being combined with radiation to improve their therapeutic index [39,40]. For instance, combination of N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers containing doxorubicin and gemcitabine with radiotherapy has shown to reduce treatment toxicity as evidenced by reduced loss in body weights in mouse models [41].…”