Theranostic Role of Advanced Nanotechnological Tools in Early Brain Metastases in Lung Cancer: An Updated Review

Abstract

Lung cancer with brain metastases remains a clinical challenge and is often diagnosed at advanced stages when treatment options are limited. Nanotechnological tools have emerged as pivotal in enhancing both diagnostic and therapeutic approaches. Herein, we explore the theranostic potential of nanotechnology for the detection and treatment of lung cancer brain metastases, focusing on nanomaterials such as liposomes, polymeric nanoparticles, quantum dots, and magnetic nanoparticles, and their applications in imaging techniques like MRI, PET, fluorescence imaging, and CT. The role of nanotechnology in overcoming the blood-brain barrier and facilitating targeted drug delivery through passive and active targeting is also discussed. Additionally, it examines the application of nanocarriers in chemotherapy, radiotherapy, immunotherapy, and combination therapies. Special attention is given to immune-modulating nanoparticles, including checkpoint inhibitors and nano vaccines, as key innovations in immunotherapy. Theranostic nanoparticles are highlighted for their potential in real-time treatment monitoring. In summary, nanotechnological tools offer transformative potential in oncology, advancing diagnostics, enabling targeted therapies, and improving patient survival outcomes.

Keywords: brain metastases; lung cancer; nanomaterials; nanotechnology; real-time monitoring; theranostics.

Figure 1

Mechanisms of Brain Metastasis in Lung Cancer. Primary lung cancer cells move from the primary tumor site to overspread and circulate in blood vessels, called circulating tumor cells (CTC). In response to chemokines, CTCs can reach the brain and cross the blood-brain barrier by rolling, adherence and extravasation Angiogenesis leads to brain metastasis.

Figure 2

Magnetic nanoparticles (MNPs) are used in cancer detection and treatment due to their ability to be controlled by an external magnetic field. MNPs can also be used as MRI probes to track metastatic lymph nodes in cancer patients due to bioimaging advances. MNPs may be preferentially phagocytosed by normal lymphoid cells after injection, darkening T2*-weighted pictures. Metastatic lymph nodes that do not absorb nanoparticles have high signal intensity on T2*-weighted imaging. Adapted from Yan Y, Liu Y, Li T, et al. Functional roles of magnetic nanoparticles for the identification of metastatic lymph nodes in cancer patients. J Nanobiotechnol. 2023;21(1):337. Under the terms and conditions of Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).

Figure 3

The diagram illustrates the two strategies for Nanotechnological therapeutic targeting in brain metastasis: passive and active targeting.

Figure 4

Schematic representation of the preparation for HM-Lipo-ICG and its application in NIR fluorescence imaging of GBM-bearing mice, including tumor margin delineation and surgical resection guidance. The HM-Lipo-ICG facilitated high-contrast NIR-imaging in glioblastoma regions of an orthotopic glioma murine model, and enhanced tumor margins detection accuracy. Adapted from Liu P, Lan S, Gao D, et al. Targeted blood-brain barrier penetration and precise imaging of infiltrative glioblastoma margins using hybrid cell membrane-coated ICG liposomes. J Nanobiotechnol. 2024;22(1):603. Under the terms and conditions of Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).