Nanotechnology-driven strategies in postoperative cancer treatment: innovations in drug delivery systems

Abstract

Cancer remains a global health challenge, and this challenge comes with a significant burden. Current treatment modalities, such as surgery, chemotherapy, and radiotherapy, have their limitations. The emergence of nanomedicines presents a new frontier in postoperative cancer treatment, offering potential to inhibit tumor recurrence and manage postoperative complications. This review deeply explores the application and potential of nanomedicines in the treatment of cancer after surgery. In particular, it focuses on local drug delivery systems (LDDS), which consist of in situ injection, implantation, and spraying. LDDS can provide targeted drug delivery and controlled release, which enhancing therapeutic efficacy. At the same time, it minimizes damage to healthy tissues and reduces systemic side effects. The nanostructures of these systems are unique. They facilitate the sustained release of drugs, prolong the effects of treatment, and decrease the frequency of dosing. This is especially beneficial in the postoperative period. Despite their potential, nanomedicines have limitations. These include high production costs, concerns regarding long-term toxicity, and complex regulatory approval processes. This paper aims to analyze several aspects. These include the advantages of nanomedicines, their drug delivery systems, how they combine with multiple treatment methods, and the associated challenges. Future research should focus on certain issues. These issues are stability, tumor specificity, and clinical translation. By addressing these, the delivery methods can be optimized and their therapeutic efficacy enhanced. With the advancements in materials science and biomedical engineering, the future design of LDDS is set to become more intelligent and personalized. It will cater to the diverse needs of clinical treatment and offer hope for better outcomes in cancer patients after surgery.

Keywords: anti-cancer; combination therapies; local drug delivery system; nanomedicines; postoperative treatment.

FIGURE 1

Schematic illustration of the local drug delivery systems (LDDSs). There are three typical strategies within LDDSs, including in situ injection, in situ implantation, in situ spraying.

FIGURE 2

The scheme illustrates the application of local drug delivery systems (LDDSs) in the postoperative treatment of various tumors. The LDDSs are combined with chemotherapy, phototherapy, immunotherapy, and immunocyte therapy.

FIGURE 3

The scheme illustrates the application of DOXC₁₂-LNC^CL for postoperative local treatment of GBM. Reprinted with permission from Ref (Wang et al., 2023). Copyright 2024 Springer.

FIGURE 4

The scheme illustrates a multifunctional photothermal ferric citrate hydrogel scaffold (GPDF) for the treatment of postoperative melanoma. Reprinted with permission from Ref (Luo et al., 2022). Copyright 2022 Elsevier.

FIGURE 5

The scheme illustrates an in situ self-assembling hydrogel LDDS (THINRTHINR-CXCL10) based on oligopeptides for the treatment of a postoperative mouse model of GBM. Reprinted with permission from Ref (Zhang J. et al., 2021). Copyright 2021 Springer Nature.

FIGURE 6

The scheme illustrates a hydrogel scaffold based on sodium alginate to load metformin and CAR-T cells (CAR-T@Met/gel) for the post-surgical tumor models of gastric and pancreatic cancers. Reprinted with permission from Ref (Chao et al., 2023). Copyright 2023 Elsevier.

FIGURE 7

The scheme illustrates an in situ injectable dual pH-responsive hydrogel for enhancing adoptive NK cell therapy to prevent post-resection HCC recurrence. Reprinted with permission from Ref (Cheng et al., 2022). Copyright 2022 Elsevier.

FIGURE 8

The scheme illustrates a polydopamine (PDA)-coated composite (PDA@DH/PLGA) for simultaneously repairing bone defects and preventing tumor recurrence. Reprinted with permission from Ref (Lu et al., 2021). Copyright 2021 American Chemical Society.

FIGURE 9

Schematic illustration of the versatile OBC-based membrane for achieving a therapeutic effect in antitumor immunotherapy towards HNSCC postoperative treatment.

FIGURE 10

Schematic illustration of the biopolymer immune implant BI(R848 + aOX40) for preventing CRC postoperative tumor relapse and metastasis. Reprinted with permission from Ref (Ji et al., 2020). Copyright 2020 WILEY.

FIGURE 11

(A) Schematic illustration of the 3D-ENHANCE loaded with NK cells for preventing postoperative tumor relapse. (B) Macroporous architecture of 3D-ENHANCE. i) Photograph of 3D-ENHANCE. ii) The scanning electronic microscopic image for 3D – ENHANCE. iii) Bright field image of NK cell clusters formed in 3D-ENHANCE. iv) Live cell image of NK cell cluster formed in 3D-ENHANCE. v) Bright field image of NK cell cultured in the 2D manner. Reprinted with permission from Ref (Ahn et al., 2020). Copyright 2020 Elsvier.

FIGURE 12

Schematic illustration of the in situ sprayed bioresponsive fibrin gel containing aCD47@CaCO₃ nanoparticles for preventing postoperative tumor local recurrence. Reprinted with permission from Ref (Chen et al., 2018). Copyright 2018 Springer Nature.

FIGURE 13

Schematic illustration of LDDS in postoperative complications. (a) Schematic illustration of FSiNCs-based nanohydrogel LDDS for anti-bacteria. Reprinted with permission from Ref (Chu et al., 2021). Copyright 2022 WILEY. (b) Schematic illustration of a trauma-inflammationresponsive and alleviating hydrogel scaffold LDDS for inflammation alleviation. Reprinted with permission from Ref (Li et al., 2022). Copyright 2022 American Chemical Society. (c) Schematic illustration of GODM-gel LDDS for swift hemostasis. Reprinted with permission from Ref (Cheng et al., 2022). Copyright 2022 Elsevier. (d) Schematic illustration of the fabrication process and the mechanism of action of the dual-drug loaded electrospun membrane LDDS for anti-adhesion. Reprinted with permission from Ref (Wang R. et al., 2024). Copyright 2024 WILEY.