Chapter 26 - Application of Theranostics to Measure and Treat Cell Heterogeneity in Cancer

Abstract

Individualized therapy is a noble anticipation in oncology. It would permit not only to adapt a treatment to an individual’s physiology and characteristics, but also to pinpoint therapeutic features for each neoplasia. The high degree of cell heterogeneity in cancer, with mixtures of cells of different origins and cell populations that evolve toward multiple genomic and epigenomic profiles, makes the precise targeting and treatment of each abnormal cell a priority. The phenotypic nature of heterogeneity in cancer is largely determined by changes in gene transcription requiring the identification of an increasing number of intracellular and even intranuclear markers. Such a requirement brings new challenges for state-of-the-art technology focusing on single-cell analysis and begs for the development of nanotools that can provide the multiplex approach necessary to target cancer locations and reach, detect, and appropriately treat subgroups of cells. In this chapter we introduce the reader to the origins of cell heterogeneity in cancer and discuss how this emerging knowledge has shed light on the difficulties encountered in the management of neoplasias over the past few decades. Our analysis illustrates how nanotheranostics might help effectively address the issue of cell heterogeneity to halt cancer progression, overcome resistance to treatment, and possibly decrease cancer risks among individuals.