Abstract
Metastatic breast cancer represents a diagnostic and therapeutic challenge due to tumor heterogeneity and to various physiological barriers that hinder drug delivery to the metastatic sites. To overcome these limitations, nanoformulated drugs have been developed and tested in preclinical studies, and few of them have been successfully translated into clinical practice. In particular, liposomal anthracyclines and nanoformulated albumin-bound paclitaxel have revealed an improved therapeutic index when compared to conventional chemotherapy, with significant reduction of drugs toxicity. Several strategies for nanoparticles engineering have more recently been explored to increase selectivity for tumor cells and to reach poorly accessible metastatic districts. Targeted nanoparticles, directed toward tumor markers and tissue-specific metastases, may provide effective devices in case of low-vascularized and small-sized metastases, thus paving the way for a real change in the natural history of metastatic disease. A number of targets have been identified and exploited for surface functionalization of different types of nanoparticles, which are currently undergoing preclinical studies. The aim of this review is to provide an overview of current nanotechnology applied to metastatic breast cancer diagnosis and treatment. Promising results encourage an upcoming translation of this research into clinical practice for an effective management of the disease in the near future.
Highlights
Metastatic breast cancer (MBC) is a major cause of cancerrelated death among women in developed countries [1]
While some chemotherapy regimens have failed to increase patients survival, the advent of the antibody trastuzumab has significantly improved the overall survival for human epidermal growth factor receptor 2- (HER2-) positive MBC, a highly aggressive cancer prone to brain metastases [5, 6]
The aim of this review is to provide a state of the art in nanotechnology applied to MBC treatment, from nanoformulated drugs already used in clinical practice to novel functionalized nanoparticles for targeted therapy and diagnosis
Summary
Metastatic breast cancer (MBC) is a major cause of cancerrelated death among women in developed countries [1]. Taxanes have been introduced in clinical practice with a substantial benefit in overall survival, time to progression, and cancer response [10] Despite their significant antitumor activity, doxorubicin and taxanes are associated with a number of severe side effects due to their toxicity profile. Various common sites of breast cancer metastases, such as the brain, are poorly accessible sanctuaries for cancer cells and require smart and innovative drug delivery systems [12] In this context, nanotechnology represents a promising field of research, since nanoformulation of drugs may improve their bioavailability and allow the selective targeting of tumor cells, with subsequent increased efficacy and lower toxicity.
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