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Roy S, Bag N, Bardhan S, Hasan I, Guo B. Recent Progress in NIR-II Fluorescence Imaging-guided Drug Delivery for Cancer Theranostics. Adv Drug Deliv Rev 2023; 197:114821. [PMID: 37037263 DOI: 10.1016/j.addr.2023.114821] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/12/2023]
Abstract
Fluorescence imaging in the second near-infrared window (NIR-II) has become a prevalent choice owing to its appealing advantages like deep penetration depth, low autofluorescence, decent spatiotemporal resolution, and a high signal-to-background ratio. This would expedite the innovation of NIR-II imaging-guided drug delivery (IGDD) paradigms for the improvement of the prognosis of patients with tumors. This work systematically reviews the recent progress of such NIR-II IGDD-mediated cancer therapeutics and collectively brings its essence to the readers. Special care has been taken to assess their performances based on their design approach, such as enhancing their drug loading and triggering release, designing intrinsic and extrinsic fluorophores, and/ or overcoming biological barriers. Besides, the state-of-the-art NIR-II IGDD platforms for different therapies like chemo-, photodynamic, photothermal, chemodynamic, immuno-, ion channel, gas-therapies, and multiple functions such as stimulus-responsive imaging and therapy, and monitoring of drug release and therapeutic response, have been updated. In addition, for boosting theranostic outcomes and clinical translation, the innovation directions of NIR-II IGDD platforms are summarized, including renal-clearable, biodegradable, sub-cellular targeting, and/or afterglow, chemiluminescence, X-ray excitable NIR-IGDD, and even cell therapy. This review will propel new directions for safe and efficient NIR-II fluorescence-mediated anticancer drug delivery.
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Affiliation(s)
- Shubham Roy
- Shenzhen Key Laboratory of Flexible Printed Electronics Technology and School of Science, Harbin Institute of Technology, Shenzhen-518055, China
| | - Neelanjana Bag
- Department of Physics, Jadavpur University, Kolkata-700032, India
| | - Souravi Bardhan
- Department of Physics, Jadavpur University, Kolkata-700032, India
| | - Ikram Hasan
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Bing Guo
- Shenzhen Key Laboratory of Flexible Printed Electronics Technology and School of Science, Harbin Institute of Technology, Shenzhen-518055, China.
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Survival of esophageal and gastric cancer patients with adjuvant and palliative chemotherapy-a retrospective analysis of a register-based patient cohort. Eur J Clin Pharmacol 2020; 76:1029-1041. [PMID: 32372150 PMCID: PMC7306049 DOI: 10.1007/s00228-020-02883-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/24/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The survival of esophageal and gastric cancer patients treated with chemotherapy is rarely assessed outside of clinical trials. Therefore, we compared the effectiveness of various curative or palliative chemotherapy regimens on the survival of esophageal and gastric cancer patients in a "real world" clinical setting. METHODS We identified a cohort of 966 incident esophageal and gastric cancer patients in Stockholm/Gotland County (a low-risk Western population) during 2008-2013. Patients who received chemotherapy with curative intention (n = 279) and palliative intention (n = 182) were analyzed separately. Using Cox proportional hazards regression models, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) and adjusted for the potential confounding factors: age, sex, TNM stage, radiotherapy, comorbidity, marital status, education, income, and country of birth. RESULTS In esophageal cancer patients with curative treatment intention, we observed a higher hazard for death among patients who received carboplatin-fluorouracil compared to patients who received cisplatin-fluorouracil, corresponding to a HR of 2.18 (95% CI 1.09-4.37). Conversely, in patients with cancer in the gastroesophageal junction who had a curative treatment intention at diagnosis, we observed a reduced hazard for death among those who received fluorouracil-oxaliplatin, compared to patients who received cisplatin-fluorouracil (HR 0.28; 95% CI 0.08-0.96). CONCLUSION Among patients with esophageal cancer who received treatment with curative intention, cisplatin-fluorouracil was associated with better survival compared to carboplatin-fluorouracil, while patients with gastroesophageal junction cancer who were treated with cisplatin-fluorouracil had worse survival compared to fluorouracil-oxaliplatin.
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South Asian Medicinal Compounds as Modulators of Resistance to Chemotherapy and Radiotherapy. Cancers (Basel) 2016; 8:cancers8030032. [PMID: 26959063 PMCID: PMC4810116 DOI: 10.3390/cancers8030032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/05/2016] [Accepted: 02/29/2016] [Indexed: 12/29/2022] Open
Abstract
Cancer is a hyperproliferative disorder that involves transformation, dysregulation of apoptosis, proliferation, invasion, angiogenesis and metastasis. During the last 30 years, extensive research has revealed much about the biology of cancer. Chemotherapy and radiotherapy are the mainstays of cancer treatment, particularly for patients who do not respond to surgical resection. However, cancer treatment with drugs or radiation is seriously limited by chemoresistance and radioresistance. Various approaches and strategies are employed to overcome resistance to chemotherapy and radiation treatment. Many plant-derived phytochemicals have been investigated for their chemo- and radio-sensitizing properties. The peoples of South Asian countries such as India, Pakistan, Sri Lanka, Nepal, Bangladesh and Bhutan have a large number of medicinal plants from which they produce various pharmacologically potent secondary metabolites. The medicinal properties of these compounds have been extensively investigated and many of them have been found to sensitize cancer cells to chemo- and radio-therapy. This review focuses on the role of South Asian medicinal compounds in chemo- and radio-sensitizing properties in drug- and radio-resistant cancer cells. Also discussed is the role of South Asian medicinal plants in protecting normal cells from radiation, which may be useful during radiotherapy of tumors to spare surrounding normal cells.
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Yang C, Huang W, Yan L, Wang Y, Wang W, Liu D, Zuo X. Downregulation of the expression of B‑cell lymphoma-extra large by RNA interference induces apoptosis and enhances the radiosensitivity of non‑small cell lung cancer cells. Mol Med Rep 2015; 12:449-55. [PMID: 25683634 DOI: 10.3892/mmr.2015.3346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 01/27/2015] [Indexed: 11/05/2022] Open
Abstract
B-cell lymphoma-extra large (Bcl-xL), an important member of anti-apoptotic Bcl-2 family, is involved in tumor progression and development. The overexpression of Bcl-xL is associated with radioresistance of human malignancies. The present study aimed to investigate the inhibitory effect of small interfering RNA (siRNA) on the expression of Bcl-xL in the A549 non-small lung cancer (NSCLC) cell line, and its role in inducing the apoptosis and increasing the radiosensitivity of A549 cells. An siRNA expression vector, pSilencer4-CMVneo-short hairpin (sh)RNA, was constructed and stably transfected into A549 cells. The effects of Bcl-xL-shRNA on cell proliferation, apoptosis and the protein expression levels of associated proteins were assessed in vitro in the A549 cells. The radiosensitivity of the A549 cells was evaluated using a clonogenic cell survival assay. The results demonstrated that the sequence-specific siRNA targeting Bcl-xL efficiently and specifically downregulated the mRNA and protein expression levels of Bcl-xL. The RNA interference-mediated downregulation in the expression of Bcl-xL inhibited cell proliferation, induced apoptosis and reduced the radioresistance of the NSCLC cells. These findings suggested that Bcl-xL may be a promising therapeutic approach for the treatment of NSCLC.
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Affiliation(s)
- Changbin Yang
- Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Wei Huang
- Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Ling Yan
- Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Yu Wang
- Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Weili Wang
- Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Dezhi Liu
- Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
| | - Xiaojun Zuo
- Department of Nuclear Medicine, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China
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HDAC Inhibitors: A New Radiosensitizer for Non-small-cell Lung Cancer. TUMORI JOURNAL 2015; 101:257-62. [PMID: 25953446 DOI: 10.5301/tj.5000347] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 12/18/2022]
Abstract
For many decades, lung cancer has been the most common cancer and the leading cause of cancer death worldwide. More than 50% of non-small-cell lung cancer patients receive radiotherapy (alone or in combination with chemotherapy or surgery) during their treatment. The intrinsic radiosensitivity of tumors and dose-limiting toxicity restrict the curative potential of radiotherapy. Histone deacetylase inhibitors (HDACis) are an emerging class of agents that target histone deacetylase and represent promising radiosensitizers that affect various biological processes, such as cell growth, apoptosis, DNA repair, and terminal differentiation. Histone deacetylase inhibitors have been found to suppress many important DNA damage responses by downregulating proteins in the homologous recombination and nonhomologous end joining repair pathways in vitro. In this review, we describe the rationale for using HDACis as radiosensitizers and the clinical evidence regarding the use of HDACis for the treatment of non-small-cell lung cancer.
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Yu SD, Liu FY, Wang QR. Notch inhibitor: a promising carcinoma radiosensitizer. Asian Pac J Cancer Prev 2013; 13:5345-51. [PMID: 23317182 DOI: 10.7314/apjcp.2012.13.11.5345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Radiotherapy is an important part of modern cancer management for many malignancies, and enhancing the radiosensitivity of tumor cells is critical for effective cancer therapies. The Notch signaling pathway plays a key role in regulation of numerous fundamental cellular processes. Further, there is accumulating evidence that dysregulated Notch activity is involved in the genesis of many human cancers. As such, Notch inhibitors are attractive therapeutic agents, although as for other anticancer agents, they exhibit significant and potential side effects. Thus, Notch inhibitors may be best used in combination with other agents or therapy. Herein, we describe evidence supporting the use of Notch inhibitors as novel and potent radiosensitizers in cancer therapy.
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Affiliation(s)
- Shu-Dong Yu
- Department of Otolaryngology, Qianfoshan Hospital Affiliated to Shandong University, Shandong, China.
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Li W, Zhan P, De Clercq E, Lou H, Liu X. Current drug research on PEGylation with small molecular agents. Prog Polym Sci 2013. [DOI: 10.1016/j.progpolymsci.2012.07.006] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ziegler R. Mistletoe Preparation Iscador: Are there Methodological Concerns with Respect to Controlled Clinical Trials? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2009; 6:19-30. [PMID: 18955241 PMCID: PMC2644282 DOI: 10.1093/ecam/nem121] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Accepted: 06/07/2007] [Indexed: 11/14/2022]
Abstract
In Europe many cancer patients use complementary therapies, particularly mistletoe. Only a few controlled clinical trials have been performed with the mistletoe preparation Iscador as a complementary treatment for cancer, many of them with medium to low quality due to methodological shortcomings. Reasons for some quality concerns, particularly discontinuation of treatment and/or participation and premature termination are analyzed. Analysis is based on controlled clinical trials dealing with Iscador. Data stem from the archive of published and ongoing research of the <> (Society for Cancer Research) in Arlesheim, Switzerland. Controlled clinical studies with cancer patients that were started after 01.01.1990 or were not completed by then have been evaluated. Fifty-six controlled studies are documented, 24 of them randomized and 32 non-randomized. Nine of the randomized studies were done by matched-pair design, the others by conventional parallel group design; six of the last were terminated prematurely primarily for slow recruitment due to patient preferences and compliance of physicians. Patient and physician preference seem to be important factors limiting recruitment for randomized trials and hence implementation. This adds to the overall unwillingness of participation by patients with serious diseases. A well-balanced mix of designs using different research methods and outcomes is suggested combined with analyses, in countries where mistletoe therapy in general or Iscador in particular is unknown or not available.
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Affiliation(s)
- Renatus Ziegler
- Verein für Krebsforschung, Institut Hiscia, Kirschweg 9, CH-4144 Arlesheim, Switzerland;
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Kostakoglu L. Variables Involved in Measuring Cancer Response to Treatment. PET Clin 2008; 3:13-36. [PMID: 27158145 DOI: 10.1016/j.cpet.2008.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this article, the discussions about concepts involved in anticancer therapy, including cell death pathways and the variables that guide clinical management, such as intents and types of anticancer therapy regimens and modalities, are a prelude to the review of FDG PET/CT imaging parameters used in the evaluation of response to therapy. The review also includes brief discussions about differences between evaluation of cytostatic and cytotoxic therapy regimens and induction and neoadjuvant therapy regimens.
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Affiliation(s)
- Lale Kostakoglu
- PET/CT Oncology and Research, Division of Nuclear Medicine, Department of Radiology, Mount Sinai Medical Center, One Gustave Levy Place, Box 1141, New York, NY 10029, USA.
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Abstract
BACKGROUND Metastatic colorectal cancer has a poor prognosis, and the majority of patients are left with palliative measures. The development seen using palliative chemotherapy is reviewed. MATERIAL AND METHODS A systematic approach to the literature-based evidence was aimed at. RESULTS The continuous improvements during the past 13-15 years have been documented in several large conclusive trials. At the end of the 1980s, the evidence that chemotherapy should be used at all was very limited, whereas presently most patients can be offered two lines of chemotherapy based upon good scientific evidence. Median survival has gradually improved from below 6 months to above 18 months in some recent trials. Several important issues remain to be solved, such as the best sequence of treatments, what regimens to use in various situations, when to start and when to stop if a response is seen, and whether cure may be possible in a small subset of patients. CONCLUSIONS Progress has been rapid in advanced colorectal cancer. This is likely a result of well-designed trials in collaboration between academy and industry, showing a great interest in the disease. Future collaborations may hopefully introduce new treatment concepts, further improving outcome.
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Affiliation(s)
- B Glimelius
- Department of Oncology, Radiology and Clinical Immunology, University Hospital, Uppsala, Sweden.
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Janunger KG, Hafström L, Glimelius B. Chemotherapy in gastric cancer: a review and updated meta-analysis. THE EUROPEAN JOURNAL OF SURGERY = ACTA CHIRURGICA 2003; 168:597-608. [PMID: 12699095 DOI: 10.1080/11024150201680005] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED The five years survival rate for patients with gastric cancer is 15-25%. With the aim of improving survival, chemotherapy has been used in different adjuvant settings. Similarly, but with the aim of improving quality of life and prolonging life, chemotherapy has been used extensively in metastatic disease. In this review we have included studies of systemic and intraperitoneal chemotherapy given before, during or after operation and for advanced disease. A meta-analysis has been made on the 21 randomised studies that used adjuvant systemic chemotherapy postoperatively. A significant survival benefit for the patients treated postoperatively compared with controls was identified (odds ratio (OR) 0.84, 95% confidence interval (CI) 0.74 to 0.96). When western and Asian studies were analysed separately we found no survival benefit for the treated patients in the western groups (OR 0.96 (95 CI 0.83 to 1.12)). Flaws in the conduct of several trials made it difficult to draw firm conclusions, including the exclusion of a small but clinically meaningful survival benefit. Preoperative or neoadjuvant chemotherapy has shown effects in some patients, but no significant benefit was found in the few randomised studies. The few studies that reported intraperitoneal therapy showed no detectable survival benefit either. In patients with advanced disease, four small randomised studies found significantly longer survival in the treated patients. The survival benefit is in the range of 3-9 months, and there were also improvements of the quality of life. Several drug combinations have been tested, however, with no confirmed superiority for a particular regimen. CONCLUSIONS Adjuvant chemotherapy cannot be recommended as a routine because of the lack of confirmed beneficial effects. Some patients with advanced disease will have a clinically important benefit from palliative chemotherapy, so this can be recommended for patients who are otherwise in good health.
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Affiliation(s)
- Karl-Gunnar Janunger
- Department of Surgical and Perioperative Sciences--Surgery, University Hospital, Umeå, Sweden.
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Berglund A, Molin D, Larsson A, Einarsson R, Glimelius B. Tumour markers as early predictors of response to chemotherapy in advanced colorectal carcinoma. Ann Oncol 2002; 13:1430-7. [PMID: 12196369 DOI: 10.1093/annonc/mdf220] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To evaluate the reliability and validity of serum carcinoembryonic antigen (CEA), tissue polypeptide-specific antigen (TPS), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in monitoring palliative chemotherapy in advanced colorectal cancer (ACRC). METHODS Serum was prospectively collected from 87 patients with ACRC treated with first-line 5-fluorouracil and leucovorin before and 2, 4 and 10 weeks after induction. RESULTS Eight patients had normal baseline TPS levels, and these patients had a favourable outcome with prolonged survival and a higher rate of objective responses than patients with elevated TPS levels. At 10 weeks, all responders had a decreasing TPS value. The sensitivity for a decrease of >25% using TPS was 83% and 86% for objective and subjective responses, respectively, and the specificity was 65% and 72%, respectively. CEA had, in the same setting, a sensitivity of 45% and 46%, respectively, and the specificity was 88%. VEGF was elevated in 54% of the patients and bFGF in 15% of the patients. The VEGF values decreased during therapy in 94% of the patients, but the changes in serial VEGF values did not correlate with survival or response. Tumour markers used together did not enhance the predictive values of TPS alone. CONCLUSIONS Repeated measurements of CEA, VEGF and bFGF in serum are of limited value in monitoring chemotherapy in ACRC. TPS seems to be of greater interest, but does not predict exactly which patients are going to have a positive outcome of palliative chemotherapy.
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Affiliation(s)
- A Berglund
- Departments of Oncology, Radiology and Clinical Immunology, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden.
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Glimelius BLG. The role of preoperative and postoperative radiotherapy in rectal cancer. Clin Colorectal Cancer 2002; 2:82-92. [PMID: 12453322 DOI: 10.3816/ccc.2002.n.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Radiotherapy has an important role to play when used in addition to surgery in primary and recurrent rectal cancer. In primary resectable rectal cancer, a large number of randomized trials have shown that preoperative radiotherapy can slightly improve survival and can decrease local recurrence rates by more than half. Postoperative radiotherapy may also decrease the risk of local failure although with less efficacy. A preoperative schedule of 5 Gy/day for 5 out of 7 days is a convenient and low-toxic treatment, provided it is not given with 2 beams to large volumes, and it appears to be at least as effective as postoperative radiochemotherapy, generally meaning 6 months of therapy with 5 weeks of radiation. The schedule of 5 Gy/day for 5 days also reduces local recurrences with total mesorectal excision. It is unlikely that preoperative radiochemotherapy will substantially increase the chances of a sphincter-preserving procedure in a low-lying rectal cancer and that the long-term function will be adequate even if this is believed by many. In primary nonresectable or locally recurrent rectal cancer, preoperative radiotherapy may downsize or downstage the tumor so that it can be resected. Scientific support that radiochemotherapy is more efficient than radiotherapy alone in this situation is weak.
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Affiliation(s)
- Bengt L G Glimelius
- Department of Oncology, Radiology and Clinical Immunology, Section of Oncology, University Hospital, SE-751 85 Uppsala, Sweden.
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Abstract
Radiotherapy has an established role in the treatment of rectal cancer. In primary resectable cancer, numerous randomised trials have shown that particularly pre-operative, and to some extent also postoperative, radiotherapy substantially reduces the risk of local failure. This is seen also with total mesorectal excision. Secondary to the reduction in local failures, there is also a slight improvement in survival after pre-operative radiotherapy or postoperative radiochemotherapy. Using appropriate techniques, the morbidity of radiotherapy is low. In non-resectable cancer, radiotherapy may cause down-staging, allow surgery, and may cure some patients. Whether radiochemotherapy is more efficient has yet to be firmly established. The role of pre-operative radio(chemo)therapy to permit more sphincter-preserving procedures with adequate long-term function is not defined.
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Affiliation(s)
- Bengt Glimelius
- Department of Oncology, Radiology and Clinical Immunology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
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