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A shift in focus towards precision oncology, driven by revolutionary nanodiagnostics; revealing mysterious pathways in colorectal carcinogenesis

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Abstract

Multiple molecular mechanisms contribute to the development of colorectal cancer (CRC), with chromosomal instability (CIN) playing a significant role. CRC is influenced by mutations in several important genes, including APC, TP53, KRAS, PIK3CA, BRAF, and SMYD4. The three molecular subtypes of this disease are CIN, MSI-H, and CIMP (CpG-island phenotype). p53 dysfunction and aberrant Wnt signalling are common characteristics of CRC carcinogenesis. Despite advances in conventional therapy, metastatic CRC remains difficult to treat due to toxicity and resistance. Theranostics for cancer could significantly benefit from nanotechnology, as it would enable more targeted, individualised care with fewer side effects. Utilising functionalized nanoparticles has enabled MRI-guided gene therapy, magnetic hyperthermia, chemotherapy, immunotherapy, and photothermal/photodynamic therapy, thereby radically modifying the way cancer is treated. Active targeting using ligands or peptides on nanoparticles improves the delivery of drugs to cancer cells. Nanostructures such as drug peptide conjugates, chitosan nanoparticles, gold nanoparticles, carbon nanotubes, mesoporous silica-based nanoparticles, silver nanoparticles, hybrid lipid–polymer nanoparticles, iron oxide nanoparticles, and quantum dots may enable targeted drug delivery and enhanced therapeutic efficacy against CRC. Nanomedicines are presently being evaluated in clinical trials for the treatment of colorectal cancer, with the promise of more effective and individualised therapies. This article examines current nanomedicine patents for CRC, including the work of Delta-Fly, Merrimack, and Pfenning, Meaning & Partner, among others. In terms of future nanomedicine research and development, ligand production, particle size, and clearance are crucial factors. Lastly, the numerous nanostructures utilized in nanomedicine for targeted drug administration and diagnostics indicate optimistic prospects for enhancing CRC treatment. The successes of nanomedicine research and development for existing colon cancer treatments are also highlighted in this review.

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Abbreviations

CRC:

Colorectal cancer

APC:

Adenomatous Polyposis Coli

TP53:

Tumor Protein 53 (p53)

KRAS:

Kirsten Rat Sarcoma Viral Oncogene Homolog

PIK3CA:

Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Alpha

BRAF:

B-Raf Proto-Oncogene, Serine/Threonine Kinase

SMAD4:

SMAD Family Member 4

FAP:

Familial Adenomatous Polyposis

HNPCC:

Hereditary Non-Polyposis Colon Carcinoma

MSI-H:

Microsatellite Instability-High

CIN:

Chromosomal instability

CIMP:

CpG Island Methylation Phenotype

Wnt:

Wingless/integrated

TCF:

T-cell factor

MSS:

Microsatellite Stable

mCRC:

Metastatic Colorectal Carcinoma

EPR:

Enhanced Permeation and Retention

NPs:

Nanoparticles

PET:

Positron Emission Tomography

MRI:

Magnetic Resonance Imaging

SPIONs:

Super Paramagnetic Iron Oxide Nanoparticles

NIR:

Near-infrared

PLNPs:

Luminescent nanoparticles

NLCs:

Nanostructured lipid carriers

CPPs:

Cell-penetrating peptides

CTPs:

Cell-targeting peptides

CXCR4:

C-X-C Chemokine Receptor Type 4

PDCs:

Drug Peptide Conjugates

CT:

Chemotherapy

RT-CT:

Radiotherapy–chemotherapy

RGD:

Arg-Gly-Asp

FDA:

Food and drug administration

siRNAs:

Small Interfering RNAs

ROS:

Reactive Oxygen species

TK NPs:

Tumor-Targeted Nanoparticles with siRNA Payloads

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Acknowledgements

The authors are thankful to the department of Pharmaceuticals, Ministry of Chemical and Fertilizers, Govt. of India, for providing the necessary support to carry out this study.

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SS, KJ, SB: literature collection and first draft; SS: valuable suggestion; SS: supervision and final correction.

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Correspondence to Sankha Bhattacharya.

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Sharma, S., Bhattacharya, S., Joshi, K. et al. A shift in focus towards precision oncology, driven by revolutionary nanodiagnostics; revealing mysterious pathways in colorectal carcinogenesis. J Cancer Res Clin Oncol 149, 16157–16177 (2023). https://doi.org/10.1007/s00432-023-05331-8

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