Abstract

Lung cancer is among the most prevalent and leading causes of death worldwide. The major reason for high mortality is the late diagnosis of the disease, and in most cases, lung cancer is diagnosed at fourth stage in which the cancer has metastasized to almost all vital organs. The other reason for higher mortality is the uptake of the chemotherapeutic agents by the healthy cells, which in turn increases the chances of cytotoxicity to the healthy body cells. The complex pathophysiology of lung cancer provides various pathways to target the cancerous cells. In this regard, upregulated onco-receptors on the cell surface of tumor including epidermal growth factor receptor (EGFR), integrins, transferrin receptor (TFR), folate receptor (FR), cluster of differentiation 44 (CD44) receptor, etc. could be exploited for the inhibition of pathways and tumor-specific drug targeting. Further, cancer borne immunological targets like T-lymphocytes, myeloid-derived suppressor cells (MDSCs), tumor-associated macrophages (TAMs), and dendritic cells could serve as a target site to modulate tumor activity through targeting various surface-expressed receptors or interfering with immune cell-specific pathways. Hence, novel approaches are required for both the diagnosis and treatment of lung cancers. In this context, several researchers have employed various targeted delivery approaches to overcome the problems allied with the conventional diagnosis of and therapy methods used against lung cancer. Nanoparticles are cell nonspecific in biological systems, and may cause unwanted deleterious effects in the body. Therefore, nanodrug delivery systems (NDDSs) need further advancement to overcome the problem of toxicity in the treatment of lung cancer. Moreover, the route of nanomedicines’ delivery to lungs plays a vital role in localizing the drug concentration to target the lung cancer. Surface-modified nanoparticles and hybrid nanoparticles have a wide range of applications in the field of theranostics. This cross-disciplinary review summarizes the current knowledge of the pathways implicated in the different classes of lung cancer with an emphasis on the clinical implications of the increasing number of actionable molecular targets. Furthermore, it focuses specifically on the significance and emerging role of surface functionalized and hybrid nanomaterials as drug delivery systems through citing recent examples targeted at lung cancer treatment.

Highlights

  • Lung cancer is one of the most prevalent diseases and the leading causes of death worldwide [1]

  • transferrin receptor (TFR) is highly upregulated in lung cancer; about 88% of nonsmall cell lung cancer (NSCLC) cases have elevated TFR-1 levels [61]

  • The results showed that the signal detection platform showed greater sensitivity with the limit of detection of 1.2 × 10−17 mol L−1 for PIK3CA gene from lung malignancy

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Summary

Introduction

Lung cancer is one of the most prevalent diseases and the leading causes of death worldwide [1]. It is more common in males than in females and based on an estimation, this type of cancer caused 154,050 deaths in 2018 [2]. The major limitation of conventional chemotherapy is related to the presence of inefficient drugs at the target site, which compromises the therapeutic efficacy [4]. To reduce this problem, repeated administration of systemic chemotherapy at higher concentrations is required, which is allied with dose-related systemic toxicities. Novel approaches are required for both the diagnosis and treatment of lung cancers [5]

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