Implantable fibrous 'patch' enabling preclinical chemo-photothermal tumor therapy

Exploring the vast potentials and probable limitations of novel and nanostructured implantable drug delivery systems for cancer treatment

Conventional cancer chemotherapy regimens, albeit successful to some extent, suffer from some significant drawbacks, such as high-dose requirements, limited bioavailability, low therapeutic indices, emergence of multiple drug resistance, off-target distribution, and adverse effects. The main goal of developing implantable drug delivery systems (IDDS) is to address these challenges and maintain anti-cancer drugs directly at the intended sites of therapeutic action while minimizing inevitable side effects. IDDS possess numerous advantages over conventional drug delivery, including controlled drug release patterns, one-time drug administration, as well as loading and stabilizing poorly water-soluble chemotherapy drugs. Here, we summarized conventional and novel (three-dimensional (3D) printing and microfluidic) preparation techniques of different IDDS, including nanofibers, films, hydrogels, wafers, sponges, and osmotic pumps. These systems could be designed with high biocompatibility and biodegradability features using a wide variety of natural and synthetic polymers. We also reviewed the published data on these systems in cancer therapy with a particular focus on their release behavior. Various release profiles could be attained in IDDS, which enable predictable, adjustable, and sustained drug releases. Furthermore, multi-step or stimuli-responsive drug release could be obtained in these systems. The studies mentioned in this article have proven the effectiveness of IDDS for treating different cancer types with high prevalence, including breast cancer, and aggressive cancer types, such as glioblastoma and liver cancer. Additionally, the challenges in applying IDDS for efficacious cancer therapy and their potential future developments are also discussed. Considering the high potential of IDDS for further advancements, such as programmable release and degradation features, further clinical trials are needed to ensure their efficiency. The overall goal of this review is to expand our understanding of the behavior of commonly investigated IDDS and to identify the barriers that should be addressed in the pursuit of more efficient therapies for cancer. See also the graphical abstract(Fig. 1).

A Comprehensive Review of Electrospun Fibers, 3D-Printed Scaffolds, and Hydrogels for Cancer Therapies

Anticancer therapies and regenerative medicine are being developed to destroy tumor cells, as well as remodel, replace, and support injured organs and tissues. Nowadays, a suitable three-dimensional structure of the scaffold and the type of cells used are crucial for creating bio-inspired organs and tissues. The materials used in medicine are made of non-degradable and degradable biomaterials and can serve as drug carriers. Developing flexible and properly targeted drug carrier systems is crucial for tissue engineering, regenerative medicine, and novel cancer treatment strategies. This review is focused on presenting innovative biomaterials, i.e., electrospun nanofibers, 3D-printed scaffolds, and hydrogels as a novel approach for anticancer treatments which are still under development and awaiting thorough optimization.

A Modular Composite Device of Poly(Ethylene Oxide)/Poly(Butylene Terephthalate) (PEOT/PBT) Nanofibers and Gelatin as a Dual Drug Delivery System for Local Therapy of Soft Tissue Tumors

In the clinical management of solid tumors, the possibility to successfully couple the regeneration of injured tissues with the elimination of residual tumor cells left after surgery could open doors to new therapeutic strategies. In this work, we present a composite hydrogel-electrospun nanofiber scaffold, showing a modular architecture for the delivery of two pharmaceutics with distinct release profiles, that is potentially suitable for local therapy and post-surgical treatment of solid soft tumors. The composite was obtained by coupling gelatin hydrogels to poly(ethylene oxide)/poly(butylene terephthalate) block copolymer nanofibers. Results of the scaffolds' characterization, together with the analysis of gelatin and drug release kinetics, displayed the possibility to modulate the device architecture to control the release kinetics of the drugs, also providing evidence of their activity. In vitro analyses were also performed using a human epithelioid sarcoma cell line. Furthermore, publicly available expression datasets were interrogated. Confocal imaging showcased the nontoxicity of these devices in vitro. ELISA assays confirmed a modulation of IL-10 inflammation-related cytokine supporting the role of this device in tissue repair. In silico analysis confirmed the role of IL-10 in solid tumors including 262 patients affected by sarcoma as a negative prognostic marker for overall survival. In conclusion, the developed modular composite device may provide a key-enabling technology for the treatment of soft tissue sarcoma.

Photothermal scaffolds/surfaces for regulation of cell behaviors

Regulation of cell behaviors and even cell fates is of great significance in diverse biomedical applications such as cancer treatment, cell-based therapy, and tissue engineering. During the past decades, diverse methods have been developed to regulate cell behaviors such as applying external stimuli, delivering exogenous molecules into cell interior and changing the physicochemical properties of the substrates where cells adhere. Photothermal scaffolds/surfaces refer to a kind of materials embedded or coated with photothermal agents that can absorb light with proper wavelength (usually in near infrared region) and convert light energy to heat; the generated heat shows great potential for regulation of cell behaviors in different ways. In the current review, we summarize the recent research progress, especially over the past decade, of using photothermal scaffolds/surfaces to regulate cell behaviors, which could be further categorized into three types: (i) killing the tumor cells via hyperthermia or thermal ablation, (ii) engineering cells by intracellular delivery of exogenous molecules via photothermal poration of cell membranes, and (iii) releasing a single cell or an intact cell sheet via modulation of surface physicochemical properties in response to heat. In the end, challenges and perspectives in these areas are commented.

A Review on Hydrogels with Photothermal Effect in Wound Healing and Bone Tissue Engineering

Photothermal treatment (PTT) is a promising strategy to deal with multidrug-resistant bacteria infection and promote tissue regeneration. Previous studies demonstrated that hyperthermia can effectively inhibit the growth of bacteria, whereas mild heat can promote cell proliferation, further accelerating wound healing and bone regeneration. Especially, hydrogels with photothermal properties could achieve remotely controlled drug release. In this review, we introduce a photothermal agent hybrid in hydrogels for a photothermal effect. We also summarize the potential mechanisms of photothermal hydrogels regarding antibacterial action, angiogenesis, and osteogenesis. Furthermore, recent developments in photothermal hydrogels in wound healing and bone regeneration applications are introduced. Finally, future application of photothermal hydrogels is discussed. Hydrogels with photothermal effects provide a new direction for wound healing and bone regeneration, and this review will give a reference for the tissue engineering.

Electrospun gold nanorods/graphene oxide loaded-core-shell nanofibers for local delivery of paclitaxel against lung cancer during photo-chemotherapy method

The combinations of photothermal therapy (PTT) and chemotherapy (CHT) have attracted increasing attention for cancer therapy. In the present study, paclitaxel as an anticancer drug and graphene oxide/gold nanorods (GO/Au NRs) were simultaneously loaded into the poly (tetramethylene ether) glycol based-polyurethane (PTMG-PU) (core)/chitosan (shell) nanofibers prepared by the coaxial electrospinning method. The potential of the synthesized nanofiber as a pH/temperature dual responsive carrier was investigated for the controlled release of paclitaxel against A549 lung cancer during PTT/CHT combined method. The synthesized core-shell nanofibers were characterized using SEM, TEM and XRD analysis. The drug encapsulation efficiency, drug release and kinetic studies were carried out. The compatibility of the synthesized core-shell nanofibers was also investigated. The cell viability of the synthesized nanofibers treated with A549 lung cancer cells was investigated under alone CHT, alone PTT and PTT/CHT method. The in vivo studies indicated that the PTT/CHT method demonstrated an optimal therapeutic effect on tumor inhibition without change in body weight. The obtained results demonstrated that the synthesized core-shell nanofibers would be used for lung cancer treatment under NIR irradiation in the future.

Build an implanted "arsenal": detachable microneedles for NIR-triggered cancer photothermo-chemotherapy

The current trend in tumor research is shifting from monotherapy to multimodal therapy. However, how to achieve on-demand drug delivery and minimize the invasiveness of treatment are still big challenges. Herein, we present a detachable microneedles (MNs) system, which consists of polycaprolactone (PCL) needles and polyvinylpyrrolidone/poly (vinyl alcohol) substrate, to build an implanted drug depot for on-demand photothermo-chemotherapy. Owing to the dissolvability of the substrate, detachable MNs can intradermally implant PCL needles loaded with photothermal conversion agent Prussian blue nanocubes (PB NCs) and chemotherapeutics doxorubicin hydrochloride (Dox·HCl). Once near-infrared light irradiates, PB NCs could translate light to local regional hyperthermia, which not only ablates cancer cells but also meltPCL to accelerate the diffusion of Dox·HCl. These MNs displayed a stable and repeatable photothermal effect under NIR irradiation. The ex vivo experiments using isolated swine skin demonstrated the as needed Dox·HCl delivery triggered by NIR light. Moreover, the robust antitumor efficacy of the MN system was proved in KB tumor-bearing nude mice under three timed NIR irradiation. Therefore, the developed detachable MNs which could build implanted "arsenal" for on-demand photothermo-chemotherapy have a bright future in tumor suppression.

Tearable and Fillable Composite Sponges Capable of Heat Generation and Drug Release in Response to Alternating Magnetic Field

Tearable and fillable implants are used to facilitate surgery. The use of implants that can generate heat and release a drug in response to an exogenous trigger, such as an alternating magnetic field (AMF), can facilitate on-demand combined thermal treatment and chemotherapy via remote operation. In this study, we fabricated tearable sponges composed of collagen, magnetite nanoparticles, and anticancer drugs. Crosslinking of the sponges by heating for 6 h completely suppressed undesirable drug release in saline at 37 °C but allowed drug release at 45 °C. The sponges generated heat immediately after AMF application and raised the cell culture medium temperature from 37 to 45 °C within 15 min. Heat generation was controlled by switching the AMF on and off. Furthermore, in response to heat generation, drug release from the sponges could be induced and moderated. Thus, remote-controlled heat generation and drug release were achieved by switching the AMF on and off. The sponges destroyed tumor cells when AMF was applied for 15 min but not when AMF was absent. The tearing and filling properties of the sponges may be useful for the surgical repair of bone and tissue defects. Moreover, these sponges, along with AMF application, can facilitate combined thermal therapy and chemotherapy.

Progress in the design and development of "fast-dissolving" electrospun nanofibers based drug delivery systems - A systematic review

Electrospinning has emerged as most viable approach for the fabrication of nanofibers with several beneficial features that are essential to various applications ranging from environment to biomedicine. The electrospun nanofiber based drug delivery systems have shown tremendous advancements over the controlled and sustained release complemented from their high surface area, tunable porosity, mechanical endurance, offer compatible environment for drug encapsulation, biocompatibility, high drug loading and tailorable release characteristics. The dosage formulation of poorly water-soluble drugs often faces several challenges including complete dissolution with maximum therapeutic efficiency over a short period of time especially through oral administration. In this context, challenges associated with the dosage formulation of poorly-water soluble drugs can be addressed through combining the beneficial features of electrospun nanofibers. This review describes major developments progressed in the preparation of electrospun nanofibers based "fast dissolving" drug delivery systems by employing variety of polymers, drug molecules and encapsulation approaches with primary focus on oral delivery. Furthermore, the review also highlights current scientific challenges and provide an outlook with regard to future prospectus.