Tumor evolution-targeted nanomedicine<sup>EVT</sup>

Abstract

<p indent="0mm">With the recent development of nanotechnology, the integration of nanotechnology with cancer therapy significantly improves the patients’ treatment outcomes. Nanomedicines have drawn great attention due to their increased drug solubility, prolonged blood circulation, increased accumulation and retention in the tumors, thereby ultimately resulting in improved therapeutic effects and biosafety. Notably, tumor biology study has indicated that tumor is constant in dynamic evolution under the internal survival pressure as well as external treatment pressure during therapeutic interventions, including radiotherapy, chemotherapy, molecular targeted therapy, and immunotherapy. These pressures further induced genetic mutations or amplifications of specific genes, resulting in tumor proliferation, drug resistance, and metastasis. Therefore, the therapeutic drugs and regimens should be tuned according to the tumor evolution characteristics. Unfortunately, current design of nanomedicines fails to take into consideration of tumor evolution. Herein, we propose a unique concept of tumor evolution-targeted nanomedicine (nanomedicine^EVT) by fully understanding the tumor evolution process related to proliferation, drug resistance, and metastasis under natural selection or therapeutic pressures. On this basis, nanomedicine^EVT could be designed, which therefore would actively, tactically, and timely attack the tumors. In this way, tumors are expected to become chronic diseases by combination of nanomedicine^EVT and other therapeutic regimens in clinic.