Abstract
Simple SummaryMalignant melanoma is the most aggressive skin cancer; its incidence is constantly growing in the white population. In the advanced stage of the disease, after metastatic dissemination, patients have a poor prognosis. Nanomedicine represents a new frontier in cancer treatment; in this field, synthetic and natural nanoparticles (NPs) may represent an important therapeutic and diagnostic opportunity. This review provides an overview of current knowledge in this area: several kinds of NPs, like PLGA, chitosan, liposome and gold-NPs, are used to increase the specificity of drug delivery, allowing a dose reduction and, consequently, a lower toxic effect. Particular attention is given to exosomes (EXOs), an example of natural NPs, important both in conveying molecules with a therapeutic function and in the diagnostic field.Advanced melanoma is still a major challenge in oncology. In the early stages, melanoma can be treated successfully with surgery and the survival rate is high, nevertheless the survival rate drops drastically after metastasis dissemination. The identification of parameters predictive of the prognosis to support clinical decisions and of new efficacious therapies are important to ensure patients the best possible prognosis. Recent progress in nanotechnology allowed the development of nanoparticles able to protect drugs from degradation and to deliver the drug to the tumor. Modification of the nanoparticle surface by specific molecules improves retention and accumulation in the target tissue. In this review, we describe the potential role of nanoparticles in advanced melanoma treatment and discuss the current efforts of designing polymeric nanoparticles for controlled drug release at the site upon injection. In addition, we highlight the advances as well as the challenges of exosome-based nanocarriers as drug vehicles. We place special focus on the advantages of these natural nanocarriers in delivering various cargoes in advanced melanoma treatment. We also describe the current advances in knowledge of melanoma-related exosomes, including their biogenesis, molecular contents and biological functions, focusing our attention on their utilization for early diagnosis and prognosis in melanoma disease.
Highlights
Advanced cutaneous melanoma is a highly aggressive and drug-resistant cancer [1,2]
Alegre et al evaluated the presence of the melanoma biomarkers melanoma inhibitory activity (MIA) protein, S100B and tyrosinase-related protein 2 (TYRP2) in EXOs derived from serum obtained from stage IV melanoma patients, melanoma-free patients and healthy controls
Despite the availability of new therapies discovered in recent years, metastatic melanoma remains a highly lethal disease
Summary
Advanced cutaneous melanoma is a highly aggressive and drug-resistant cancer [1,2]. The main problem associated with treating melanoma is its low response rate to conventional therapy. In order to circumvent the intrinsic resistance against as result of genome sequencing and identification of the main mutation, a series of therapeutic chemotherapy, researchers explored the possibility of potentiating the immune response by using agents have been discovered; about half of all melanomas have mutations in the BRAF (v-raf immune stimulators, such as interleukin 2 (IL-2), interferon alpha (IFN-α), ipilimumab and thymosin murine sarcoma viral oncogene homolog B1) gene [8,9]. These mutations constitutively activate alpha 1 [6,7].
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