Pretherapy Ferumoxytol-enhanced MRI to Predict Response to Liposomal Irinotecan in Metastatic Breast Cancer

Histopathological biomarkers for predicting the tumour accumulation of nanomedicines

“…The overall aim of this study is to establish a robust and straightforward protocol for patient stratification in clinical trials of cancer nanomedicines. For obvious reasons, the protocol should eventually predict treatment outcome rather than tumour accumulation of the nanomedicine (even though multiple previous preclinical and clinical papers have convincingly shown that the tumour accumulation of nanomedicines correlates well with treatment outcomes [8][9][10][11][12][13][14] ). A key limitation of the study is that, owing to ethical and practical constraints, we were not able to correlate the tumour-tissue biomarker score with nanomedicine treatment efficacy, but could only robustly demonstrate a correlation between biomarker product score and nanomedicine tumour accumulation.…”

“…Considering that tumour accumulation is crucial for good therapeutic outcome and, conversely, that individuals not showing good tumour accumulation should be excluded from clinical trials of cancer nanomedicines, it is imperative to establish probes or protocols for quantitative assessment and accurate prediction of nanomedicine target-site localization. It has already been shown in mouse models and patients with cancer that the tumour accumulation of companion diagnostics [8][9][10][11] and nanomedicine theranostics [12][13][14] corresponds well with treatment outcomes from nanomedicines, particularly if patients are not pre-treated too heavily before being enroled in clinical trials. While in principle highly quantitative and properly predictive, monitoring nanomedicine tumour targeting via magnetic resonance imaging, computed tomography (CT) and positron emission tomography (PET) is not straightforward and not very time efficient and cost efficient 4 .…”

Mechanisms and Barriers in Nanomedicine: Progress in the Field and Future Directions

“…Using magnetic resonance imaging (MRI) nanoprobes or targeted gold nanoparticles for computed tomography (CT), it may be possible to prescreen and select responsive patients before administering nanomedicines. In this context, FDA-approved iron oxide nanoparticle ferumoxytol is inexpensive and safe (no radiation), and could be employed for patient stratification. , Dynamic contrast-enhanced (DCE) and dynamic susceptibility (DSC) MRI with gadolinium contrast or ferumoxytol can noninvasively assess perfusion and vascular leakage in cancer lesions that indirectly correlate with nanomedicine accumulation . Ultrasound techniques, including Doppler, B-mode imaging, elastography, super-resolution, and contrast-enhanced ultrasound (CEUS), hold promise for predicting nanoparticle distribution and therapeutic effectiveness in solid tumors.…”