Smart cancer nanomedicine

• Published in: Nature nanotechnology Vol. 14; no. 11; pp. 1007 - 1017
• Main Authors: van der Meel, Roy, Sulheim, Einar, Shi, Yang, Kiessling, Fabian, Mulder, Willem J. M., Lammers, Twan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-11-2019; Nature Publishing Group
• Subjects: 631/61/350/354; 631/61/54/152; 639/925/350; 639/925/352; Animals; Anticancer properties; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Biomarkers, Tumor - analysis; Cancer; Cancer therapies; Chemistry and Materials Science; Clinical trials; Drug Carriers - chemistry; Drug Delivery Systems - methods; Drug development; Drug Development - methods; Humans; Immunotherapy; Immunotherapy - methods; Lymphoid cells; Materials Science; Nanomedicine - methods; Nanoparticles - chemistry; Nanotechnology; Nanotechnology and Microengineering; Neoplasms - diagnosis; Neoplasms - therapy; Oncology; Patients; Perspective; Synergism; Therapy; Translational Research, Biomedical - methods
• ISSN: 1748-3387; 1748-3395
• DOI: 10.1038/s41565-019-0567-y

Nanomedicines are extensively employed in cancer therapy. We here propose four strategic directions to improve nanomedicine translation and exploitation. (1) Patient stratification has become common practice in oncology drug development. Accordingly, probes and protocols for patient stratification are urgently needed in cancer nanomedicine, to identify individuals suitable for inclusion in clinical trials. (2) Rational drug selection is crucial for clinical and commercial success. Opportunistic choices based on drug availability should be replaced by investments in modular (pro)drug and nanocarrier design. (3) Combination therapies are the mainstay of clinical cancer care. Nanomedicines synergize with pharmacological and physical co-treatments, and should be increasingly integrated in multimodal combination therapy regimens. (4) Immunotherapy is revolutionizing the treatment of cancer. Nanomedicines can modulate the behaviour of myeloid and lymphoid cells, thereby empowering anticancer immunity and immunotherapy efficacy. Alone and especially together, these four directions will fuel and foster the development of successful cancer nanomedicine therapies.
The use of nanomedicine in cancer requires the adoption of specific strategies to optimize its potential. This perspective proposes four strategies including the identification of patients for clinical trials, investments in modular nanocarrier design, the integration in multimodal combination therapy regimes and the inclusion in immunotherapy studies