Enabling individualized therapy through nanotechnology

Abstract

Individualized medicine is the healthcare strategy that rebukes the idiomatic dogma of 'losing sight of the forest for the trees'. We are entering a new era of healthcare where it is no longer acceptable to develop and market a drug that is effective for only 80% of the patient population. The emergence of "-omic" technologies (e.g. genomics, transcriptomics, proteomics, metabolomics) and advances in systems biology are magnifying the deficiencies of standardized therapy, which often provide little treatment latitude for accommodating patient physiologic idiosyncrasies. A personalized approach to medicine is not a novel concept. Ever since the scientific community began unraveling the mysteries of the genome, the promise of discarding generic treatment regimens in favor of patient-specific therapies became more feasible and realistic. One of the major scientific impediments of this movement towards personalized medicine has been the need for technological enablement. Nanotechnology is projected to play a critical role in patient-specific therapy; however, this transition will depend heavily upon the evolutionary development of a systems biology approach to clinical medicine based upon "-omic" technology analysis and integration. This manuscript provides a forward looking assessment of the promise of nanomedicine as it pertains to individualized medicine and establishes a technology "snapshot" of the current state of nano-based products over a vast array of clinical indications and range of patient specificity. Other issues such as market driven hurdles and regulatory compliance reform are anticipated to "self-correct" in accordance to scientific advancement and healthcare demand. These peripheral, non-scientific concerns are not addressed at length in this manuscript; however they do exist, and their impact to the paradigm shifting healthcare transformation towards individualized medicine will be critical for its success.

Fig. 1

The iceberg: the promise of “-omic” technologies. Nanotechnology will play a critical role in the discovery and validation of future biomarkers by providing access to a wealth of information provided by “-omic” technologies. Furthermore, nanotechnology offers a mechanism to utilize this patient-specific information to create novel individualized therapies and treatment strategies for patients in form of implantable devices, diagnostics, contrast agents, and innovative drug-delivery vectors.

Fig. 2

Design maps for spherical beads as a function of the patient-specific parameter β and F[90].

Fig. 3

Schematic of fracture putty.

Fig. 4

Schematic presentation of three generations of therapeutic nanovectors. First generation: nanoparticles localizing in tumor through the EPR passive mechanism; second generation: nanovectors possessing additional level of complexity such as (a) remote activation by means of radiofrequency (RF) or near-infrared (NIR) energy or (b) active targeting through specific ligands overexpressed on tumor cells; third generation: logic embedded vectors, LEV comprised of different nano-components which act through a time-sequence of synergistic and logic-driven events.

Fig. 5

Generalized cross-section of a nanoparticle-based contrast agent, adapted from [329].

Fig. 6

Various applications of nanotechnology in regenerative medicine.