Mahri Sohaib, Villa Rodolfo, Shiau Ya-Ping, Tang Menghuan, Racacho Kelsey Jane, Zong Qiufang, Chowdhury Saiful Islam, Hua Tan, Godinez Felipe, Birkeland Andrew, Lin Tzu-Yin, Li Yuanpei
Department of Biochemistry and Molecular Medicine UC Davis Comprehensive Cancer Center University of California Davis Sacramento CA 95817 USA.
Department of Radiology University of California Davis Sacramento CA 95817 USA.
Small Sci. 2025 Apr 11;5(6):2400607. doi: 10.1002/smsc.202400607. eCollection 2025 Jun.
Cancer is a daunting global health problem with a steadily rising incidence. Despite the wide arsenal of current anticancer therapies, challenges such as drug resistance, tumor heterogeneity, poor targeting, and severe side effects often lead to suboptimal efficacy and poor patient outcomes, highlighting the need for innovative therapies. Autophagy modulation has emerged as an attractive approach to complement existing therapies. The dual role of autophagy in cancer promotion and suppression has inspired the development of new drugs and therapeutic strategies focusing on both inhibition and induction. Despite the promising results of current autophagy modulators in preclinical studies, challenges such as the lack of selectivity and potency, toxicity, poor pharmacokinetics, and inadequate tumor targeting continue to limit their successful clinical translation. Many of these challenges could be overcome using nanomedicine. This review explores recent advancements in nanomedicine strategies for autophagy modulation. Successful combination strategies leveraging nanoparticles and autophagy modulators in synergy with chemotherapy, immunotherapy, phototherapy, gene therapy, and other modalities are presented. Additionally, nanomaterials with intrinsic autophagy-modulating capabilities, such as self-assembling autophagy inhibitors, are discussed. Finally, limitations of autophagy modulators currently in clinical trials are discussed, and future perspectives on designing nanomedicine for successful clinical implementation are explored.
癌症是一个令人生畏的全球健康问题,其发病率在稳步上升。尽管目前有各种各样的抗癌疗法,但诸如耐药性、肿瘤异质性、靶向性差和严重副作用等挑战往往导致疗效欠佳和患者预后不良,这凸显了创新疗法的必要性。自噬调节已成为一种有吸引力的补充现有疗法的方法。自噬在癌症促进和抑制中的双重作用激发了专注于抑制和诱导的新药及治疗策略的开发。尽管目前的自噬调节剂在临床前研究中取得了令人鼓舞的结果,但诸如缺乏选择性和效力、毒性、药代动力学不佳以及肿瘤靶向性不足等挑战仍然限制了它们成功转化为临床应用。利用纳米医学可以克服其中许多挑战。本综述探讨了纳米医学自噬调节策略的最新进展。介绍了成功的联合策略,这些策略利用纳米颗粒和自噬调节剂与化疗、免疫疗法、光疗法、基因疗法及其他方式协同作用。此外,还讨论了具有内在自噬调节能力的纳米材料,如自组装自噬抑制剂。最后,讨论了目前正在进行临床试验的自噬调节剂的局限性,并探讨了设计纳米医学以成功实现临床应用的未来前景。