Radiosensitizing high-Z metal nanoparticles for enhanced radiotherapy of glioblastoma multiforme
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(2020) 18:122 Choi et al. J Nanobiotechnol https://doi.org/10.1186/s12951-020-00684-5
Open Access
REVIEW
Radiosensitizing high‑Z metal nanoparticles for enhanced radiotherapy of glioblastoma multiforme Jinyeong Choi, Gaeun Kim, Su Bin Cho and Hyung‑Jun Im*
Abstract Radiotherapy is an essential step during the treatment of glioblastoma multiforme (GBM), one of the most lethal malignancies. The survival in patients with GBM was improved by the current standard of care for GBM established in 2005 but has stagnated since then. Since GBM is a radioresistant malignancy and the most of GBM recurrences occur in the radiotherapy field, increasing the effectiveness of radiotherapy using high-Z metal nanoparticles (NPs) has recently attracted attention. This review summarizes the progress in radiotherapy approaches for the current treat‑ ment of GBM, the physical and biological mechanisms of radiosensitization through high-Z metal NPs, and the results of studies on radiosensitization in the in vitro and in vivo GBM models using high-Z metal NPs to date. Keywords: Radiotherapy, Gold nanoparticle, Glioblastoma, Radiosensitization, High-Z material Introduction Glioblastoma multiform (GBM) is one of the most lethal malignancies with a 5-year survival rate of 5.5% and a median survival of 15 months [1]. Glioblastoma multiform is categorized as a grade IV astrocytic lineage glioma, and the most common brain malignancy, accounting for 47.1% of all malignant primary brain tumors, 82% of malignant gliomas, 56.1% of all gliomas, and 14.9% of all primary brain tumors [1, 2]. Glioblastoma multiform has an average annual incidence of approximately 11,000 in the United States. The incidence rate of GBM is higher in older people than in younger people and it is the highest in the age of 75–84 years. In addition, the incidence rate of GBM is 1.58 times higher in males than females [1]. The current standard of care for GBM includes surgery, temozolomide administration, and radiotherapy. Since GBM is considered as a *Correspondence: [email protected]; [email protected] † Jinyeong Choi and Gaeun Kim contributed equally to this work Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
radioresistant tumor [3] and most of the recurrence occurs in the radiotherapy field [4], radiosensitization of the tumor is an important target to improve the outcome in patients with GBM. Therefore, multiple radiosensitizing strategies are actively under development, including PI3K pathway inhibitors [5], DNA repair inhibitors [6], hyperthermia [7], aldehyde dehydrogenase inhibitors [8], and high atomic number (high-Z) metal nanoparticles (NPs) [9]. Nanomedicine has advantages over conventional cancer therapeutics such as multi-functionality, efficient drug delivery, and controlled release of the drug cargos [10, 11]. The efficient drug delivery in nanomedicine can be achieved either by passive targeting based on enhanced permeability and retention (EPR) effect or
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