Therapy For Treatment Of Cancer Research Articles

A BRD4‐Targeting Photothermal Agent for Controlled Protein Degradation

AbstractBRD4 protein plays a pivotal role in cell cycle regulation and differentiation. Disrupting the activity of BRD4 has emerged as a promising strategy for inhibiting the growth and proliferation of cancer cells. Herein, we introduced a BRD4‐targeting photothermal agent for controlled protein degradation, aiming to enhance low‐temperature photothermal therapy (PTT) for cancer treatment. By incorporating a BRD4 protein inhibitor into a cyanine dye scaffold, the photothermal agent specifically bond to the bromodomain of BRD4. Upon low power density laser irradiation, the agent induced protein degradation, directly destroying the BRD4 structure and inhibiting its transcriptional regulatory function. This strategy not only prolonged the retention time of the photothermal agent in cancer cells but also confined the targeted protein degradation process solely to the tumor tissue, minimizing side effects on normal tissues through the aid of exogenous signals. This work established a simple and feasible platform for future PTT agent design in clinical cancer treatment.

A BRD4-Targeting Photothermal Agent for Controlled Protein Degradation.

BRD4 protein plays a pivotal role in cell cycle regulation and differentiation. Disrupting the activity of BRD4 has emerged as a promising strategy for inhibiting the growth and proliferation of cancer cells. Herein, we introduced a BRD4-targeting photothermal agent for controlled protein degradation, aiming to enhance low-temperature photothermal therapy (PTT) for cancer treatment. By incorporating a BRD4 protein inhibitor into a cyanine dye scaffold, the photothermal agent specifically bond to the bromodomain of BRD4. Upon low power density laser irradiation, the agent induced protein degradation, directly destroying the BRD4 structure and inhibiting its transcriptional regulatory function. This strategy not only prolonged the retention time of the photothermal agent in cancer cells but also confined the targeted protein degradation process solely to the tumor tissue, minimizing side effects on normal tissues through the aid of exogenous signals. This work established a simple and feasible platform for future PTT agent design in clinical cancer treatment.

Real-world TRAE association between niraparib and platinum-based chemotherapy.

Pre-clinical studies showed the anti-tumor mechanisms of PARP inhibitors (PARPi) and platinum have some crossover and overlap in the DNA damage repair pathway, patients who respond to platinum-based chemotherapy are also more likely to be sensitive to PARPi. This real-world study mainly aimed to evaluate whether TRAE (treatment-related adverse event) between platinum based chemotherapy (PBC) and niraparib are also associated. Patients received niraparib as maintenance treatment or salvage therapy for advanced ovarian cancer at the First Affiliated Hospital of Gannan Medical University from January 2020 to August 2023 were included. Survival data of niraparib treatment and adverse events occurred during the last platinum-based chemotherapy cycle before starting niraparib treatment and during niraparib treatment are documented. Fisher's exact test were used for correlation analysis. 1. 40 patients treated with niraparib were included in the analysis, including 31 patients treated with niraparib for 1st-line maintenance therapy, 6 patients for PSR (platinum-sensitive recurrence) maintenance therapy, and 3 patients for salvage therapy. The overall median follow-up time was 15.0 months (ranged from 2.2 months to 32.1 months). 2. Overall grade≥3 TRAE (40% vs 70%, p=0.012) including anemia (20% vs 45%, p=0.041) and neutrophil count decreased (17.5% vs 57.5%, p<0.001) was significantly lower during niraparib treatment compared to during chemotherapy. 3. Any grade TRAE (75% vs 100%, p=0.002) including white blood cell count decreased (47.5% vs 87.5%, p<0.001), red blood cell count decreased (57.5% vs 92.5%, p<0.001), anemia (55% vs 87.5%, p<0.001) and neutrophil count decreased (35% vs 85%, p<0.001) were also significantly lower in niraparib treatment group compared with chemotherapy group. No new safety signals were identified. 1. In this real-world practice, we observed that patients with advanced ovarian cancer who experienced any grade and grade ≥3 TRAE during chemotherapy were well tolerated when treated with niraparib, particularly the incidence of any grade and grade ≥3 anemia, and neutrophil count decreased during niraparib treatment were significantly lower compared with that during chemotherapy. 2. For patients with ovarian cancer who have experienced grade ≥3 hematological adverse reactions during prior platinum-based chemotherapy, greater attention should be paid to the monitoring and management of hematological adverse reactions during subsequent treatment with niraparib.

Probing the optical properties and toxicological profile of zinc tungstate nanorods.

Zinc tungstate is a semiconductor known for its favorable photocatalytic, photoluminescence, and scintillation properties, coupled with its relatively low cost, reduced toxicity, and high stability in biological and catalytic environments. In particular, zinc tungstate evinces scintillation properties, namely the ability to emit visible light upon absorption of energetic radiation such as x rays, which has led to applications not only as radiation detectors but also for biomedical applications involving the delivery of optical light to deep tissue, such as photodynamic therapy and optogenetics. Here, we report on the synthesis of zinc tungstate nanorods generated via an optimized but facile method, which allows for synthetic control over the aspect ratio of the as-synthesized anisotropic motifs via rational variation of the solution pH. We investigate the effect of aspect ratio on their resulting photoluminescent and radioluminescent properties. We further demonstrate the potential of these zinc tungstate nanorods for biomedical applications, such as photodynamic therapy for cancer treatment, by analyzing their toxicological profile within cell lines and neurons.

Chimeric Antigen Receptor T-Cells (CAR T-Cells): An Engineered Targeted Therapy for Treatment of Cancer

We have undertaken this review to explore the various developments and insights of CAR-T cell therapy during 1989-2023 and its advantages in the treatment of cancer and immune modulation. It is a chimeric antigen receptor T-cell therapy, which is an innovative form of immunotherapy that harnesses the power of the immune system to fight cancer. At first, T cells are extracted from the patient’s blood through a process called leukapheresis. Then the modification has been done in T cells by genetically engineered to express chimeric antigen receptors (CARs) on their surface. These receptors are designed to recognize specific proteins, or antigens, that are found on the surface of cancer cells. Many conventional therapies available in the market for the treatment of cancer and Immuno modulation but most of them having Adverse Drug Reaction (ADR). But CAR-T cells possess upper hand on these conventional Formulations. Once a sufficient number of CAR-T cells have been produced, they are infused back into the patient’s bloodstream. Once reach inside the body, the CAR-T cells recognize and bind to the cancer cells that express the specific antigen targeted by the CAR. This triggers the destruction of the cancer cells by the immune system. CAR-T cell therapy has shown remarkable success in treating certain types of blood cancers, such as acute lymphoblastic leukaemia (ALL), chronic lymphocytic leukaemia (CLL), and certain types of lymphoma. The content of this review will pave the way to work on CAR-T cell therapy. Keywords: CAR-T, Immunotherapy, cancer, antigen, leukemia, lymphoma.

A homologous membrane-camouflaged self-assembled nanodrug for synergistic antitumor therapy

Limited success has been achieved in ferroptosis-induced cancer treatment due to the challenges related to low production of toxic reactive oxygen species (ROS) and inherent ROS resistance in cancer cells. To address this issue, a self-assembled nanodrug have been investigated that enhances ferroptosis therapy by increasing ROS production and reducing ROS inhibition. The nanodrug is constructed by allowing doxorubicin (DOX) to interact with Fe2+ through coordination interactions, forming a stable DOX-Fe2+ chelate, and this chelate further interacts with sorafenib (SRF), resulting in a stable and uniform nanoparticle. In tumor cells, overexpressed glutathione (GSH) triggers the disassembly of nanodrug, thereby activating the drug release. Interestingly, the released DOX not only activates nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) to produce abundant H2O2 production for enhanced ROS production, but also acts as a chemotherapeutics agent, synergizing with ferroptosis. To enhance tumor selectivity and improve the blood clearance, the nanodrug is coated with a related cancer cell membrane, which enhances the selective inhibition of tumor growth and metastasis in a B16F10 mice model. Our findings provide valuable insights into the rational design of self-assembled nanodrug for enhanced ferroptosis therapy in cancer treatment. Statement of significanceFerroptosis is a non-apoptotic form of cell death induced by the iron-regulated lipid peroxides (LPOs), offering a promising potential for effective and safe anti-cancer treatment. However, two significant challenges hinder its clinical application: 1) The easily oxidized nature of Fe2+ and the low concentration of H2O2 leads to a low efficiency of intracellular Fenton reaction, resulting in poor therapeutic efficacy; 2) The instinctive ROS resistance of cancer cells induce drug resistance. Therefore, we developed a simple and high-efficiency nanodrug composed of self-assembling by Fe2+ sources, H2O2 inducer and ROS resistance inhibitors. This nanodrug can effectively deliver the Fe2+ sources into tumor tissue, enhance intracellular concentration of H2O2, and reduce ROS resistance, achieving a high-efficiency, precise and safe ferroptosis therapy.

Lipid nanoparticles-based RNA therapies for breast cancer treatment

Breast cancer (BC) prevails as a major burden on global healthcare, being the most prevalent form of cancer among women. BC is a complex and heterogeneous disease, and current therapies, such as chemotherapy and radiotherapy, frequently fall short in providing effective solutions. These treatments fail to mitigate the risk of cancer recurrence and cause severe side effects that, in turn, compromise therapeutic responses in patients. Over the last decade, several strategies have been proposed to overcome these limitations. Among them, RNA-based technologies have demonstrated their potential across various clinical applications, notably in cancer therapy. However, RNA therapies are still limited by a series of critical issues like off-target effect and poor stability in circulation. Thus, novel approaches have been investigated to improve the targeting and bioavailability of RNA-based formulations to achieve an appropriate therapeutic outcome. Lipid nanoparticles (LNPs) have been largely proven to be an advantageous carrier for nucleic acids and RNA. This perspective explores the most recent advances on RNA-based technology with an emphasis on LNPs’ utilization as effective nanocarriers in BC therapy and most recent progresses in their clinical applications.Graphical

ENLIGHTED phase 3 study: Efficacy and safety of padeliporfin vascular targeted photodynamic therapy (VTP) for treatment of low-grade upper tract urothelial cancer (LG UTUC).

TPS4622 Background: Padeliporfin VTP has demonstrated safety and efficacy for UTUC treatment in a Phase 1 study (NCT03617003). Padeliporfin VTP is a combination product: a drug, padeliporfin administered IV; a device: a laser light delivery system/laser-source of light emitting near-infrared (NIR) light at 753nm; and an optic fiber delivering the light endoluminally to the vicinity of UTUC tumors within the collecting system. We report the preliminary efficacy and safety outcomes of Padeliporfin VTP for Treatment of LG UTUC in ENLIGHTED, a Phase 3 trial (NCT04620239). Methods: This is an open-label phase 3 study from USA, EU and Israel. Key inclusion criteria is up to 2 biopsy-proven LG UTUC with index tumor ≤15mm in the kidney and≤20mm in the ureter with an absence of high-grade cells on cytology. VTP is performed via retrograde upper tract endoscopy under anesthetic and low light conditions, Padeliporfin is injected IV and a laser light diffuser fiber 20-40 mm is positioned in proximity of the tumor through the scope. After Padeliporfin injection, the laser fiber is illuminated for 10 min. The fiber can be repositioned to provide up to 3 treatments within the upper tract. Patients are treated in two phases: Induction(ITP) and Maintenance Treatment Phases (MTP). ITP consists of 1-3 VTPs provided at 4-week intervals until achieving complete response (CR) or treatment failure. Patients achieving CR will proceed to the MTP and be followed with endoscopic evaluation every 3 months with VTP provided for recurrent tumors only up to 12 months. Patients with high-grade recurrences will be deemed treatment failures and removed from the study to standard of care treatment. Patients completing the MTP, will be followed for an additional 48 months for long-term outcomes. Primary outcome is CR on endoscopic evaluation and selective cytology at the time of primary response evaluation (28 ± 3 days post last treatment) during padeliporfin VTP ITP. A total of 100 patients are to be enrolled. As of 21 Jan 2024, 17 patients have been treated. 13 patients completed ITP and had CR 10/13 (77%) and PR 3/13 (23%). Patients baseline characteristics: age 67±12 years; gender: 9(53%) males and 8(47%) females; tumors location: 5(29%) in ureter, 13(76%) in the kidney; number of tumors: 7(41%) 2 tumors, 10(59%) 1 tumor. The most frequent treatment related adverse events were: flank pain 17%, vomiting 8%, fatigue 8%, nausea 6%, hematuria 6%, all Grade 1-2, resolved within few days. Grade 3 serious adverse events 9% (flank pain, hypertension, renal colic, urinary tract infection) were resolved within 2-7 days. To date Padeliporfin VTP has shown evidence of safety and efficacy with preliminary data that is consistent with prior experience. Recruitment for the ENLIGHTED trial is ongoing with results expected to provide basis for approval of a new therapy that clinically benefits pts. Clinical trial information: NCT04620239 .

Validation on selected breast cancer drugs of physicochemical features by using machine learning models

Breast cancer is one of the leading causes of death among females today. The elbow approach determines the ideal number of clusters after determining that the Dataset is highly cluster able with the Hopkins statistic. Three distinct groups with distinct differences were produced using the dataset's proposed expectation maximization fuzzy k-means clustering algorithm (PEMFKM). Different fuzzy clustering techniques, such as fuzzy k-means (FKM), fuzzy k-means with entropy (FKM.ENT), fuzzy k-means with entropy and noise (FKM.ENT.NOISE), Gustafson and Kessel - like fuzzy k-means (FKM.GK), Gustafson and Kessel - like fuzzy k-means with entropy regularization (FKM.GK.ENT), Gustafson and Kessel - like fuzzy kmeans with entropy regularization and noise (FKM.GK.ENT.NOISE), and PEMFKM, are evaluated. The partition coefficient (PC), partition entropy (PE), and Modified partition coefficient index (MPC) index values are better for FKM.GK than the suggested PEMFKM method. When compared to the FKM.GK method, the index values for the proposed PEMFKM algorithm have superior results for the parameters Silhouette (SIL), Xie and Beni index (XB), and fuzzy silhouette index (SIL.F). The results shows that the PEMFKM algorithm will provide better clusters and that the drugs in a given cluster may be combined for use in combination therapy for breast cancer treatment.

Extraction of Unstructured Electronic Health Records to Evaluate Glioblastoma Treatment Patterns.

Data on lines of therapy (LOTs) for cancer treatment are important for clinical oncology research, but LOTs are not explicitly recorded in electronic health records (EHRs). We present an efficient approach for clinical data abstraction and a flexible algorithm to derive LOTs from EHR-based medication data on patients with glioblastoma multiforme (GBM). Nonclinicians were trained to abstract the diagnosis of GBM from EHRs, and their accuracy was compared with abstraction performed by clinicians. The resulting data were used to build a cohort of patients with confirmed GBM diagnosis. An algorithm was developed to derive LOTs using structured medication data, accounting for the addition and discontinuation of therapies and drug class. Descriptive statistics were calculated and time-to-next-treatment (TTNT) analysis was performed using the Kaplan-Meier method. Treating clinicians as the gold standard, nonclinicians abstracted GBM diagnosis with a sensitivity of 0.98, specificity 1.00, positive predictive value 1.00, and negative predictive value 0.90, suggesting that nonclinician abstraction of GBM diagnosis was comparable with clinician abstraction. Of 693 patients with a confirmed diagnosis of GBM, 246 patients contained structured information about the types of medications received. Of them, 165 (67.1%) received a first-line therapy (1L) of temozolomide, and the median TTNT from the start of 1L was 179 days. We described a workflow for extracting diagnosis of GBM and LOT from EHR data that combines nonclinician abstraction with algorithmic processing, demonstrating comparable accuracy with clinician abstraction and highlighting the potential for scalable and efficient EHR-based oncology research.

Docosahexaenoic Acid Coordinating with Sodium Selenite Promotes Paraptosis in Colorectal Cancer Cells by Disrupting the Redox Homeostasis and Activating the MAPK Pathway.

Tumor cells are characterized by a delicate balance between elevated oxidative stress and enhanced antioxidant capacity. This intricate equilibrium, maintained within a threshold known as redox homeostasis, offers a unique perspective for cancer treatment by modulating reactive oxygen species (ROS) levels beyond cellular tolerability, thereby disrupting this balance. However, currently used chemotherapy drugs require larger doses to increase ROS levels beyond the redox homeostasis threshold, which may cause serious side effects. How to disrupt redox homeostasis in cancer cells more effectively remains a challenge. In this study, we found that sodium selenite and docosahexaenoic acid (DHA), a polyunsaturated fatty acid extracted from marine fish, synergistically induced cytotoxic effects in colorectal cancer (CRC) cells. Physiological doses of DHA simultaneously upregulated oxidation and antioxidant levels within the threshold range without affecting cell viability. However, it rendered the cells more susceptible to reaching the upper limit of the threshold of redox homeostasis, facilitating the elevation of ROS levels beyond the threshold by combining with low doses of sodium selenite, thereby disrupting redox homeostasis and inducing MAPK-mediated paraptosis. This study highlights the synergistic anticancer effects of sodium selenite and DHA, which induce paraptosis by disrupting redox homeostasis in tumor cells. These findings offer a novel strategy for more targeted and less toxic cancer therapies for colorectal cancer treatment.

Gene-Based Therapy for Brain Cancer: Promises and Challenges

Brain cancer, including gliomas and other malignant tumors, represents a devastating and challenging disease with limited treatment options and poor prognosis. Conventional therapies such as surgery, radiation, and chemotherapy have shown limited success, necessitating the exploration of alternative approaches. Gene-based therapy has emerged as a promising frontier in precision medicine, leveraging our growing understanding of the genetic and molecular drivers underlying brain tumor development and progression. This paper provides an overview of recent advancements in gene-based therapies for brain cancer, including gene editing techniques, gene silencing strategies, Immunotherapy, and more. Notably, these approaches aim to target specific oncogenes, tumor suppressor genes, and immune-related genes to inhibit tumor growth, induce apoptosis, and enhance the patient's immune response against cancer cells. Moreover, gene-based therapies offer the potential for personalized treatments tailored to individual patients based on their unique genetic profile, increasing treatment efficacy and minimizing adverse effects. While gene-based therapies have shown promising preclinical and early clinical results, challenges related to delivery, safety, and off-target effects remain to be addressed. This abstract emphasizes the urgent need for further research and large-scale clinical trials to establish the safety and long-term efficacy of gene-based therapies for brain cancer treatment. As the field continues to evolve, gene-based therapy holds great promise in reshaping the landscape of brain cancer management and providing hope for improved patient outcomes in the future.

Surface-Functionalized Microgels as Artificial Antigen-Presenting Cells to Regulate Expansion of T Cells.

Artificial antigen-presenting cells (aAPCs) are currently used to manufacture T cells for adoptive therapy in cancer treatment, but a readily tunable and modular system can enable both rapid T cell expansion and control over T cell phenotype. Here, it is shown that microgels with tailored surface biochemical properties can serve as aAPCs to mediate T cell activation and expansion. Surface functionalization of microgels is achieved via layer-by-layer coating using oppositely charged polymers, forming a thin but dense polymer layer on the surface. This facile and versatile approach is compatible with a variety of coating polymers and allows efficient and flexible surface-specific conjugation of defined peptides or proteins. The authors demonstrate that tethering appropriate stimulatory ligands on the microgel surface efficiently activates T cells for polyclonal and antigen-specific expansion. The expansion, phenotype, and functional outcome of primary mouse and human T cells can be regulated by modulating the concentration, ratio, and distribution of stimulatory ligands presented on microgel surfaces as well as the stiffness and viscoelasticity of the microgels.

Drug Repurposing: Exploring Potential Anti-Cancer Strategies by Targeting Cancer Signalling Pathways.

The repurposing of previously clinically approved drugs as an alternative therapeutic approach to treating disease has gained significant attention in recent years. A multitude of studies have demonstrated various and successful therapeutic interventions with these drugs in a wide range of neoplastic diseases, including multiple myeloma, leukaemia, glioblastoma, and colon cancer. Drug repurposing has been widely encouraged due to the known efficacy, safety, and convenience of already established drugs, allowing the bypass of the long and difficult road of lead optimization and drug development. Repurposing drugs in cancer therapy is an exciting prospect due to the ability of these drugs to successfully target cancer-associated genes, often dysregulated in oncogenic signalling pathways, amongst which are the classical cancer signalling pathways; WNT (wingless-related integration type) and Hippo signalling. These pathways play a fundamental role in controlling organ size, tissue homeostasis, cell proliferation, and apoptosis, all hallmarks of cancer initiation and progression. Prolonged dysregulation of these pathways has been found to promote uncontrolled cellular growth and malignant transformation, contributing to carcinogenesis and ultimately leading to malignancy. However, the translation of cancer signalling pathways and potential targeted therapies in cancer treatment faces ongoing challenges due to the pleiotropic nature of cancer cells, contributing to resistance and an increased rate of incomplete remission in patients. This review provides analyses of a range of potential anti-cancer compounds in drug repurposing. It unravels the current understanding of the molecular rationale for repurposing these drugs and their potential for targeting key oncogenic signalling pathways.

Tumor microenvironment-regulated drug delivery system combined with sonodynamic therapy for the synergistic treatment of breast cancer.

Co-loading of sonosensitizers and chemotherapeutic drugs into nanocarriers can improve the biocompatibilities, stabilities, and targeting of drugs and reduce the adverse reactions of drugs, providing a robust platform to orchestrate the synergistic interplay between chemotherapy and sonodynamic therapy (SDT) in cancer treatment. In this regard, biodegradable manganese dioxide (MnO2) has attracted widespread attention because of its unique properties in the tumor microenvironment (TME). Accordingly, herein, MnO2 nanoshells with hollow mesoporous structures (H-MnO2) were etched to co-load hematoporphyrin monomethyl ether (HMME) and doxorubicin (DOX), and DOX/HMME-HMnO2@bovine serum albumin (BSA) obtained after simple BSA modification of DOX/HMME-HMnO2 exhibited excellent hydrophilicity and dispersibility. H-MnO2 rapidly degraded in the weakly acidic TME, releasing loaded HMME and DOX, and catalysed the decomposition of H2O2 abundantly present in TME, producing oxygen (O2) in situ, significantly increasing O2 concentration and downregulating the hypoxia-inducible factor 1α (HIF-1α). After irradiation of the tumor area with low-frequency ultrasound, the drug delivery efficiency of DOX/HMME-HMnO2@BSA substantially increased, and the excited HMME generated a large amount of reactive oxygen species (ROS), which caused irreversible damage to tumor cells. Moreover, the cell death rate exceeded 60% after synergistic SDT-chemotherapy. Therefore, the pH-responsive nanoshells designed in this study can realize drug accumulation in tumor regions by responding to TME and augment SDT-chemotherapy potency for breast cancer treatment by improving hypoxia in tumors. Thus, this study provides theoretical support for the development of multifunctional nanocarriers and scientific evidence for further exploration of safer and more efficient breast cancer treatments.

In Vitro and In Vivo Synergetic Radiotherapy with Gold Nanoparticles and Docetaxel for Pancreatic Cancer.

This research underscores the potential of combining nanotechnology with conventional therapies in cancer treatment, particularly for challenging cases like pancreatic cancer. We aimed to enhance pancreatic cancer treatment by investigating the synergistic effects of gold nanoparticles (GNPs) and docetaxel (DTX) as potential radiosensitizers in radiotherapy (RT) both in vitro and in vivo, utilizing a MIA PaCa-2 monoculture spheroid model and NRG mice subcutaneously implanted with MIA PaCa-2 cells, respectively. Spheroids were treated with GNPs (7.5 μg/mL), DTX (100 nM), and 2 Gy of RT using a 6 MV linear accelerator. In parallel, mice received treatments of GNPs (2 mg/kg), DTX (6 mg/kg), and 5 Gy of RT (6 MV linear accelerator). In vitro results showed that though RT and DTX reduced spheroid size and increased DNA DSBs, the triple combination of DTX/RT/GNPs led to a significant 48% (p = 0.05) decrease in spheroid size and a 45% (p = 0.05) increase in DNA DSBs. In vivo results showed a 20% (p = 0.05) reduction in tumor growth 20 days post-treatment with (GNPs/RT/DTX) and an increase in mice median survival. The triple combination exhibited a synergistic effect, enhancing anticancer efficacy beyond individual treatments, and thus could be employed to improve radiotherapy and potentially reduce adverse effects.

An Overview of Emerging Trends in Gene Therapy for Cancer Treatment

Clinical trials have long recognized cancer treatment as a top priority. Different approaches have been devised for dealing with tumors of different types and at different stages. When it came to curing cancer, gene therapy was vital. The advancement of genome engineering technologies over the past thirty years has pushed forward gene therapy for the treatment and management of chronic diseases. It is the hope of researchers that one day they will be able to treat individuals with single gene disorders and complicated acquired diseases in a way that is both safe and successful. Gene delivery is a promising new method for detecting, diagnosing, and maybe treating cancer, made possible by recent developments in genetic engineering. Naked nucleic acid-based treatment, targeting microRNAs, oncolytic viral therapy, suicide gene-based therapy, targeting telomerase, cell-mediated gene therapeutics, and CRISPR/Cas9-based therapies are just few of the cancer medicines that have been created and tested in vitro and in vivo. This article provides a critical overview of the present and diverse cancer gene therapy methodologies, as well as a summary of the available viral and non-viral gene delivery mechanisms for gene therapy. In the future, biosafe carriers for gene products will play a crucial role in the prevention of cancer.

Advancements in CAR-T Therapy: A Comprehensive Review

Chimeric Antigen Receptor T-cell (CAR-T) therapy has emerged as a ground-breaking approach in cancer treatment, offering new hope to patients with refractory or relapsed malignancies. By genetically modifying T lymphocytes, this potent method allows for the targeted eradication of infectious cells. The efficient production of CAR-T cells is essential for the effective use of these treatments to treat malignancies, as it affects not just the product's efficacy as well as safety but also its general availability to patients who require it. This article's primary goal is to provide a comprehensive overview of CAR-T therapy, encompassing its historical evolution, mechanistic insights, clinical applications, challenges, and future directions. By synthesizing existing literature and realworld evidence, this review seeks to elucidate the significance of CAR-T therapy in the landscape of cancer treatment and its potential to redefine the standard of care for patients with refractory or relapsed malignancies. The methodology involved a comprehensive literature search conducted using various databases, including PubMed, Google Scholar, and clinical trial registries such as Clinical- Trials.gov. The search strategy incorporated a combination of relevant keywords and Medical Subject Headings (MeSH) terms, including but not limited to "CAR-T therapy," "chimeric antigen receptor T-cell therapy," "cancer immunotherapy," "clinical trials," "pharmaceutical companies," "regulatory approvals," "pipeline molecules," and "cancer types." Boolean operators (AND, OR) were utilized to refine the search and capture relevant articles and studies. In addition to database searches, manual screening of reference lists from relevant review articles and primary studies was performed to identify additional relevant publications. The inclusion criteria encompassed original research articles, clinical trials, systematic reviews, meta-analyses, and regulatory documents related to CAR-T cell therapy and its applications in cancer treatment and the review included studies published in English between January 2010 and March 2024. Exclusion criteria comprised studies not relevant to the scope of the review, such as those focusing on non-CAR-T cell therapies or non-cancer-related topics. This review underscores the transformative potential of CAR-T therapy in cancer treatment, highlighting its efficacy, safety, and clinical relevance across various malignancies. By synthesizing findings from preclinical studies, clinical trials, and real-world data from patients, CAR-T therapy has consistently exhibited remarkable therapeutic outcomes. These include high response rates, durable remissions, and significant improvements in survival outcomes among patients with refractory or relapsed cancers. Additionally, the inclusion of practical research with big data from real patients further supports the robustness and applicability of CAR-T therapy in clinical practice. In conclusion, CAR-T therapy represents a paradigm shift in cancer treatment, offering new avenues for personalized and precisiondriven oncology. By addressing current gaps, optimizing treatment protocols, and exploring novel strategies, CAR-T therapy holds immense promise in reshaping the landscape of oncology and providing hope to patients with advanced malignancies.

Better together: nanoscale co-delivery systems of therapeutic agents for high-performance cancer therapy.

Combination therapies can enhance the sensitivity of cancer to drugs, lower drug doses, and reduce side effects in cancer treatment. However, differences in the physicochemical properties and pharmacokinetics of different therapeutic agents limit their application. To avoid the above dilemma and achieve accurate control of the synergetic ratio, a nanoscale co-delivery system (NCDS) has emerged as a prospective tool for combined therapy in cancer treatment, which is increasingly being used to co-load different therapeutic agents. In this study, we have summarized the mechanisms of therapeutic agents in combination for cancer therapy, nanoscale carriers for co-delivery, drug-loading strategies, and controlled/targeted co-delivery systems, aiming to give a general picture of these powerful approaches for future NCDS research studies.

Travel-Time Disparities in Access to Proton Beam Therapy for Cancer Treatment

Proton beam therapy is an emerging radiotherapy treatment for patients with cancer that may produce similar outcomes as traditional photon-based therapy for many cancers while delivering lower amounts of toxic radiation to surrounding tissue. Geographic proximity to a proton facility is a critical component of ensuring equitable access both for indicated diagnoses and ongoing clinical trials. To characterize the distribution of proton facilities in the US, quantify drive-time access for the population, and investigate the likelihood of long commutes for certain population subgroups. This population-based cross-sectional study analyzed travel times to proton facilities in the US. Census tract variables in the contiguous US were measured between January 1, 2017, and December 31, 2021. Statistical analysis was performed from September to November 2023. Drive time in minutes to nearest proton facility. Population totals and prevalence of specific factors measured from the American Community Survey: age; race and ethnicity; insurance, disability, and income status; vehicle availability; broadband access; and urbanicity. Poor access to proton facilities was defined as having a drive-time commute of at least 4 hours to the nearest location. Median drive time and percentage of population with poor access were calculated for the entire population and by population subgroups. Univariable and multivariable odds of poor access were also calculated for certain population subgroups. Geographic access was considered for 327 536 032 residents of the contiguous US (60 594 624 [18.5%] Hispanic, 17 974 186 [5.5%] non-Hispanic Asian, 40 146 994 [12.3%] non-Hispanic Black, and 195 265 639 [59.6%] non-Hispanic White; 282 031 819 [86.1%] resided in urban counties). The median (IQR) drive time to the nearest proton facility was 96.1 (39.6-195.3) minutes; 119.8 million US residents (36.6%) lived within a 1-hour drive of the nearest proton facility, and 53.6 million (16.4%) required a commute of at least 4 hours. Persons identifying as non-Hispanic White had the longest median (IQR) commute time at 109.8 (48.0-197.6) minutes. Multivariable analysis identified rurality (odds ratio [OR], 2.45 [95% CI, 2.27-2.64]), age 65 years or older (OR, 1.09 [95% CI, 1.06-1.11]), and living below the federal poverty line (OR, 1.22 [1.20-1.25]) as factors associated with commute times of at least 4 hours. This cross-sectional study of drive-time access to proton beam therapy found that disparities in access existed among certain populations in the US. These results suggest that such disparities present a barrier to an emerging technology in cancer treatment and inhibit equitable access to ongoing clinical trials.