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Review
. 2019 Nov 25;11(12):1855.
doi: 10.3390/cancers11121855.

Thirty Years of Cancer Nanomedicine: Success, Frustration, and Hope

Lucia Salvioni  1 , Maria Antonietta Rizzuto  1 , Jessica Armida Bertolini  1 , Laura Pandolfi  2 , Miriam Colombo  1 , Davide Prosperi  1   3
Affiliations
Review

Thirty Years of Cancer Nanomedicine: Success, Frustration, and Hope

Lucia Salvioni et al. Cancers (Basel). .

Abstract

Starting with the enhanced permeability and retention (EPR) effect discovery, nanomedicine has gained a crucial role in cancer treatment. The advances in the field have led to the approval of nanodrugs with improved safety profile and still inspire the ongoing investigations. However, several restrictions, such as high manufacturing costs, technical challenges, and effectiveness below expectations, raised skeptical opinions within the scientific community about the clinical relevance of nanomedicine. In this review, we aim to give an overall vision of the current hurdles encountered by nanotherapeutics along with their design, development, and translation, and we offer a prospective view on possible strategies to overcome such limitations.

Keywords: EPR effect; cancer nanomedicine; clinical translation; nanoparticles; nano–bio interactions; tumor microenvironment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Tunable physical and chemical properties of nanocarriers (NCs).
Figure 2
Figure 2
Tumor microenvironment. Tumor tissue is characterized by a high cellular density that hampers oxygen and nutrient perfusion. Accordingly, cancer cells are genetically and epigenetically heterogeneous, and those located far from the blood vessels: (1) favor an anaerobic metabolism that leads to the environment acidification; (2) are more resistant to pharmacological treatments because of their low division rate and genetic instability [42]. Fibroblasts and pericytes are responsible for tissue remodeling, while the immunosuppressive milieu hinders immune cell activity. NCs extravasation and penetration are mainly limited by solid stress and high interstitial fluid pressure, which in certain areas may reach values close to the aortic pressure [43].
Figure 3
Figure 3
(A) Publication peak of “nanoparticles” related papers; (B) Subject areas of “nanoparticles + cancer” papers. Elaborated data are derived from the Scopus research tool.
See this image and copyright information in PMC

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