So-called “nanotheranostic” agents are under development to simultaneously deliver diagnostic-imaging contrast material and antitumor therapeutic agents to cancer cells.10-12 Most nanopharmaceuticals require “substantial optimization” before they will be ready for prime time.13 For example, iron oxide nanoparticles are promising nanotheranostic agents under preclinical and clinical study, but immune interaction challenges remain.12

Other nano-oncology agents in development include metal nanoshells (eg, gold or titanium) that allow controlled release of chemotherapy agents, small interfering RNA (siRNA)-payload nanoparticles, and antibody-drug conjugates (nanoMAbs).14 But in this arena, too, challenges persist. Optimization of nanoconjugates includes controlling the precise size, shape, surface orientation, and number or density of ligands on nanoparticles, for example.15

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Nanopharmaceuticals might come to hold an important place in multi-agent cancer treatment and its personalization. Cerulean Pharma Inc., which is developing CRLX101, has reported preclinical and early clinical efficacy data suggesting that this agent exhibits synergistic antitumor activity with antiangiogenic agents in renal cell carcinoma and ovarian cancer by reducing HIF-1-mediated tumor resistance to antiangiogenesis agents.16

Also in development are nanoparticles that will simultaneously deliver multiple anticancer agent payloads to tumor cells while exploiting synergies and helping to sidestep drug resistance.17 Researchers anticipate that, in the future, combinatorial nanopharmaceuticals might well expand the available options for personalized cancer treatment regimens, allowing clinicians to fine-tune combination treatments to the particular genetic vulnerabilities of a given tumor.13,17,18


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