1)北京大学第三医院超声医学科,北京 100191;2)血管稳态与重构全国重点实验室(北京大学),北京 100191;3)胃肠肿瘤医-X协同创新北京市重点实验室,北京 100191
国家自然科学基金(32271443),血管稳态与重构全国重点实验室(北京大学)-北京大学第三医院研究基金(2024-VHR-SY-03)和北京市自然科学基金(JQ22024,L232087)资助项目。
1)Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China;2)State Key Laboratory of Vascular Homeostasis and Remodeling (Peking University), Beijing 100191, China;3)Beijing Key Laboratory of Interdisciplinary Research in Gastrointestinal Oncology (BLGO), Beijing 100191, China
This work was supported by grants from The National Natural Science Foundation of China (32271443), Research Project of Peking University Third Hospital in State Key Laboratory of Vascular Homeostasis and Remodeling (Peking University) (2024-VHR-SY-03), and Beijing Natural Science Foundation (JQ22024, L232087).
胰腺癌(pancreatic cancers,PCs)是消化系统常见且预后极差的恶性肿瘤。其主要治疗方式包括手术、放化疗和靶向治疗等。PCs发病隐匿、早期诊断率低下,大多数患者被诊断为PCs时,已经失去了手术机会。化疗仍是进展期PCs的主要治疗方法,但是PCs化疗容易发生耐药。PCs区别于其他肿瘤最显著的特征是基质十分丰富致密,不仅阻碍了药物渗透,同时也阻碍了免疫细胞的浸润。上述原因共同导致PCs患者的生存率极低,现有药物不能满足临床PCs治疗的迫切需求。先进的药物递送系统为PCs的治疗带来新的机遇,其具有改善药物递送、增强生物屏障穿透、减少副作用等优点,同时可以联合多种治疗方法,因此在PCs治疗中的前景十分广阔。目前在PCs中广泛应用的药物递送系统主要包括纳米药物递送系统、针对肿瘤微环境的药物递送系统、免疫疗法药物递送系统、基因治疗药物递送系统以及融合各种疗法优点的组合药物递送系统等。本文就上述药物递送系统在PCs治疗中的领域发展现状、最新前沿进展和机遇挑战等进行系统总结和前瞻分析。
Pancreatic cancers (PCs) is a common malignant tumor with poor prognosis in the digestive system. Its main treatment methods include surgery, radiotherapy, chemotherapy, and targeted therapy. The early diagnosis rate of hidden onset of PCs is low, and most patients have already lost the opportunity to undergo surgery when diagnosed with PCs. Chemotherapy is still the main treatment for advanced PCs, but the use of chemotherapy drugs in PCs can easily lead to drug resistance. The most significant feature that distinguishes PCs from other tumors is its rich and dense matrix, which not only hinders drug penetration but also impedes the infiltration of immune cells. The above reasons have led to a very low survival rate of PCs patients. Therefore, drug delivery systems are very important in the diagnosis and treatment of PCs. They can improve drug delivery, enhance biological barrier penetration, reduce side effects, and combine multiple treatment methods. Therefore, the treatment prospects of PCs are very broad. Currently, drug delivery systems widely applied in PCs primarily include nanodrug delivery systems, tumor microenvironment-targeted drug delivery system, immunotherapy drug delivery system, gene therapy drug delivery system, and combination therapy drug delivery system that synergize multiple therapeutic modalities. Emerging drug delivery systems (DDSs) have revolutionized PCs treatment by addressing these challenges through multiple mechanisms. Nanoformulations improve drug solubility, prolong circulation time, and reduce systemic toxicity via passive/active targeting. Smart DDSs responsive to PCs-specific stimuli enable extracellular matrix degradation, tumor-associated fibroblasts reprogramming, and vascular normalization to enhance drug accessibility. Last but not least, carrier systems loaded with myeloid-derived suppressor cell inhibitors or T cell activators can reverse immunosuppression and potentiate immunotherapy efficacy. Advanced platforms co-deliver chemotherapeutics with immunomodulators, gene-editing tools, or sonodynamic agents to achieve synergistic antitumor effects. These platforms aim to address critical challenges in PCs treatment, such as enhancing drug bioavailability, overcoming stromal barriers, reprogramming immunosuppressive niches, and achieving multi-mechanistic antitumor effects. This article provides a systematic summary and prospective analysis of the current development status, latest cutting-edge advances, opportunities, and challenges of the above-mentioned drug delivery systems in the field of PCs therapy.
史宛瑞,崔立刚,梁晓龙.药物递送系统在胰腺癌治疗中的应用[J].生物化学与生物物理进展,2025,52(7):1745-1756
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