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    Harnessing nanomedicine for enhanced immunotherapy for breast cancer brain metastases

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    Author
    Carney, Christine P
    Pandey, Nikhil
    Kapur, Anshika
    Woodworth, Graeme F
    Winkles, Jeffrey A
    Kim, Anthony J
    Date
    2021-10-30
    Journal
    Drug Delivery and Translational Research
    Publisher
    Springer Nature
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1007/s13346-021-01039-9
    Abstract
    Brain metastases (BMs) are the most common type of brain tumor, and the incidence among breast cancer (BC) patients has been steadily increasing over the past two decades. Indeed, ~ 30% of all patients with metastatic BC will develop BMs, and due to few effective treatments, many will succumb to the disease within a year. Historically, patients with BMs have been largely excluded from clinical trials investigating systemic therapies including immunotherapies (ITs) due to limited brain penetration of systemically administered drugs combined with previous assumptions that BMs are poorly immunogenic. It is now understood that the central nervous system (CNS) is an immunologically distinct site and there is increasing evidence that enhancing immune responses to BCBMs will improve patient outcomes and the efficacy of current treatment regimens. Progress in IT for BCBMs, however, has been slow due to several intrinsic limitations to drug delivery within the brain, substantial safety concerns, and few known targets for BCBM IT. Emerging studies demonstrate that nanomedicine may be a powerful approach to overcome such limitations, and has the potential to greatly improve IT strategies for BMs specifically. This review summarizes the evidence for IT as an effective strategy for BCBM treatment and focuses on the nanotherapeutic strategies currently being explored for BCBMs including targeting the blood-brain/tumor barrier (BBB/BTB), tumor cells, and tumor-supporting immune cells for concentrated drug release within BCBMs, as well as use of nanoparticles (NPs) for delivering immunomodulatory agents, for inducing immunogenic cell death, or for potentiating anti-tumor T cell responses.
    Rights/Terms
    © 2021. The Author(s).
    Keyword
    Blood–brain barrier
    Breast cancer brain metastases
    Immune checkpoint inhibitors
    Immunotherapy
    Nanoimmunotherapies
    Nanoparticles
    Nanotechnology
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17088
    ae974a485f413a2113503eed53cd6c53
    10.1007/s13346-021-01039-9
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