Abstract
Photodynamic therapy (PDT) is a promising anticancer noninvasive method and has great potential for clinical applications. Unfortunately, PDT still has many limitations, such as metastatic tumor at unknown sites, inadequate light delivery and a lack of sufficient oxygen. Recent studies have demonstrated that photodynamic therapy in combination with other therapies can enhance anticancer effects. The development of new nanomaterials provides a platform for the codelivery of two or more therapeutic drugs, which is a promising cancer treatment method. The use of multifunctional nanocarriers for the codelivery of two or more drugs can improve physical and chemical properties, increase tumor site aggregation, and enhance the antitumor effect through synergistic actions, which is worthy of further study. This review focuses on the latest research progress on the synergistic enhancement of PDT by simultaneous multidrug administration using codelivery nanocarriers. We introduce the design of codelivery nanocarriers and discuss the mechanism of PDT combined with other antitumor methods. The combination of PDT and chemotherapy, gene therapy, immunotherapy, photothermal therapy, hyperthermia, radiotherapy, sonodynamic therapy and even multidrug therapy are discussed to provide a comprehensive understanding.
Highlights
Photodynamic therapy (PDT) emerged as a tumor treatment in 1907, and the early progression of it is closely related to the development of PSs [4]
The results showed that HIF1α downregulation directly inhibited tumor cell generation and promoted reactive oxygen species (ROS) production in the tumor environment, thereby enhancing PDTmediated apoptosis
Xia Y [129] evaluated the efficacy of CPG combined with the PS verteporfin in the treatment of 4T1 metastatic breast cancer; the results showed that the activation of DC cells was significantly increased, and the tumor volume of tumor-bearing mice was smaller than that of other control groups
Summary
Photodynamic therapy (PDT) is a modern noninvasive antitumor technique that has great clinical application potential due to its advantages of simple operation and low systemic toxicity. Local or systemic photosensitizers (PSs) can be activated to produce cytotoxic reactive oxygen species (ROS). Acute inflammatory responses and immunogenic cell death (ICD) induced by PDT have been shown to activate the body’s immune system and result in the reconstruction of the tumor microenvironment [2,3]. In type I reactions, the PSs in their excited triplet state react with biomolecules and ROS can be generated from radical oxygen species formed by electron transfer reactions such as superoxide ions (O2 − ) and hydroxyl radical (OH ). In type II reactions, the energy of PSs in their excited triplet state is transferred directly to the oxygen molecule in the basic energetic state, resulting in the generation of singlet oxygen, which is highly. The balance of the contribution of both reactions depends on many factors, including oxygen concentration and on the structural features of the PSs
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