Novel Strategies for Nanoparticle-Based Radiosensitization in Glioblastoma

Abstract

Radiotherapy (RT) is one of the cornerstones in the current treatment paradigm for glioblastoma (GBM). However, little has changed in the management of GBM since the establishment of the current protocol in 2005, and the prognosis remains grim. Radioresistance is one of the hallmarks for treatment failure, and different therapeutic strategies are aimed at overcoming it. Among these strategies, nanomedicine has advantages over conventional tumor therapeutics, including improvements in drug delivery and enhanced antitumor properties. Radiosensitizing strategies using nanoparticles (NP) are actively under study and hold promise to improve the treatment response. We aim to describe the basis of nanomedicine for GBM treatment, current evidence in radiosensitization efforts using nanoparticles, and novel strategies, such as preoperative radiation, that could be synergized with nanoradiosensitizers.

Preoperative Stereotactic Radiosurgery for Glioblastoma

“…The optimal treatment paradigm for patients with GBM requires a multidisciplinary approach that typically involves maximal surgical resection followed by radiation therapy (RT) with concurrent and adjuvant TMZ chemotherapy and, finally, tumor-treating fields (TTF) [ 5 , 6 , 7 , 8 , 9 ]. However, treatment decision making is often complex and multiple factors must be considered, such as patient age and performance status, as certain populations are more likely to benefit from either intensified or de-intensified therapies [ 4 , 57 , 58 , 59 , 60 ].…”

“…While these results failed to show a benefit to SRS, they are not reflective of current standard treatment practices, such as the use of concurrent and adjuvant TMZ [ 7 ]. Additionally, the impact of SRS sequencing in the management of GBM remains largely unknown [ 5 ].…”

“…GBM are highly aggressive tumors with a grim prognosis that are markedly resistant to treatment [ 4 , 5 ]. In the setting of optimal treatment, the median overall survival (OS) for patients with GBM ranges from 15–21 months with a 5-year OS rate of <5% [ 6 , 7 , 8 , 9 , 10 ].…”

Modernistic and Emerging Developments of Nanotechnology in Glioblastoma-Targeted Theranostic Applications

“…Hence, active targeting can have better scope due to the facile functionalization by nanomaterials such as ligands (i.e., peptides, antibodies, and specific surface proteins). A few strategies depend on the utility of monoclonal antibodies, which exhibit meritorious selectivity and specificity toward the targeted glioma tissues with an adjustable binding interaction [28]. Shevtsov et al developed superior theragnostic-based superparamagnetic iron oxide nanoparticles (SPIONs) that are conjugated with the antibodies of a membrane heat shock protein (Hsp70.1).…”

Iodine Nanoparticles (Niodx™) for Radiotherapy Enhancement of Glioblastoma and Other Cancers: An NCI Nanotechnology Characterization Laboratory Study

“…One such new method that appears very promising is the loading of high atomic number (high-Z) atoms that highly absorb X-rays to the tumors followed by RT [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. The absorbed X-rays eject inner shell electrons (the photoelectric effect) which then create tissue-damaging free radicals ( Figure 1 ).…”