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Published in: Cancer and Metastasis Reviews 3/2023

28-07-2023 | Breast Cancer | NON-THEMATIC REVIEW

Current advances in nanoformulations of therapeutic agents targeting tumor microenvironment to overcome drug resistance

Authors: Sajad Fakhri, Seyed Zachariah Moradi, Farahnaz Faraji, Tara Farhadi, Osman Hesami, Amin Iranpanah, Kassidy Webber, Anupam Bishayee

Published in: Cancer and Metastasis Reviews | Issue 3/2023

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Abstract

The tumor microenvironment (TME) plays a pivotal role in cancer development and progression. In this line, revealing the precise mechanisms of the TME and associated signaling pathways of tumor resistance could pave the road for cancer prevention and efficient treatment. The use of nanomedicine could be a step forward in overcoming the barriers in tumor-targeted therapy. Novel delivery systems benefit from enhanced permeability and retention effect, decreasing tumor resistance, reducing tumor hypoxia, and targeting tumor-associated factors, including immune cells, endothelial cells, and fibroblasts. Emerging evidence also indicates the engagement of multiple dysregulated mediators in the TME, such as matrix metalloproteinase, vascular endothelial growth factor, cytokines/chemokines, Wnt/β-catenin, Notch, Hedgehog, and related inflammatory and apoptotic pathways. Hence, investigating novel multitargeted agents using a novel delivery system could be a promising strategy for regulating TME and drug resistance. In recent years, small molecules from natural sources have shown favorable anticancer responses by targeting TME components. Nanoformulations of natural compounds are promising therapeutic agents in simultaneously targeting multiple dysregulated factors and mediators of TME, reducing tumor resistance mechanisms, overcoming interstitial fluid pressure and pericyte coverage, and involvement of basement membrane. The novel nanoformulations employ a vascular normalization strategy, stromal/matrix normalization, and stress alleviation mechanisms to exert higher efficacy and lower side effects. Accordingly, the nanoformulations of anticancer monoclonal antibodies and conventional chemotherapeutic agents also improved their efficacy and lessened the pharmacokinetic limitations. Additionally, the coadministration of nanoformulations of natural compounds along with conventional chemotherapeutic agents, monoclonal antibodies, and nanomedicine-based radiotherapy exhibits encouraging results. This critical review evaluates the current body of knowledge in targeting TME components by nanoformulation-based delivery systems of natural small molecules, monoclonal antibodies, conventional chemotherapeutic agents, and combination therapies in both preclinical and clinical settings. Current challenges, pitfalls, limitations, and future perspectives are also discussed.
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Metadata
Title
Current advances in nanoformulations of therapeutic agents targeting tumor microenvironment to overcome drug resistance
Authors
Sajad Fakhri
Seyed Zachariah Moradi
Farahnaz Faraji
Tara Farhadi
Osman Hesami
Amin Iranpanah
Kassidy Webber
Anupam Bishayee
Publication date
28-07-2023
Publisher
Springer US
Published in
Cancer and Metastasis Reviews / Issue 3/2023
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI
https://doi.org/10.1007/s10555-023-10119-w

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