International Journal of Nanomedicine (Dec 2022)
Carbon Nanotubes as Carriers in Drug Delivery for Non-Small Cell Lung Cancer, Mechanistic Analysis of Their Carcinogenic Potential, Safety Profiling and Identification of Biomarkers
Abstract
Zhongjian Pu,1,* Yujia Wei,2,3,* Yuanpeng Sun,1 Yajun Wang,1 Shilin Zhu1 1Department of Oncology, Haian Hospital of Traditional Chinese Medicine, Haian, 216600, People’s Republic of China; 2School of Medicine, Yangzhou University, Yangzhou, 225009, People’s Republic of China; 3Department of General Practice, Suzhou Wuzhong Hospital of Traditional Chinese Medicine, Suzhou, 215101, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yajun Wang; Shilin Zhu, Department of Oncology, Haian Hospital of Traditional Chinese Medicine, Haian, 216600, People’s Republic of China, Email [email protected]; [email protected]: Non-small cell lung cancer (NSCLC) is a global burden leading to millions of deaths worldwide every year. Nanomedicine refers to the use of materials at the nanoscale for drug delivery and subsequent therapeutic approaches in cancer. Carbon nanotubes (CNTs) are widely used as nanocarriers for therapeutic molecules such as plasmids, siRNAs, antisense agents, aptamers and molecules related to the immunotherapy for several cancers. They are usually functionalized and loaded with standard drug molecules to improve their therapeutic efficiency. Functionalization and drug loading possibly decrease the genotoxic and carcinogenic potential of CNTs. In addition, the targeted cytotoxic properties of the drug improve and undesired toxicity decreases after drug loading and/or conjugation with proteins, including antibodies. For intended drug delivery, a lysosomal pH of 5.5 is more suitable and effective for the slow and extended release of cytotoxic drugs than a physiological of pH 7.4. Remarkably, CNTs possess intrinsic antitumor properties and are usually internalized by endocytosis. After being internalized, several mechanisms are involved in the therapeutic and carcinogenic effects of CNTs. They are generally safe for therapy, and their toxicity profile remains dependent on their physicochemical properties. Moreover, the dose, route, duration of exposure, surface properties and degradative potential determine the toxicity outcomes of CNTs locally or systemically. In summary, the use of CNTs in drug delivery and NSCLC therapy, as well as their genotoxic and carcinogenic potential and the possible mechanisms, has been discussed in this review. The therapeutic index is generally high for NSCLC cells treated with drug-loaded CNTs; therefore, they are effective carriers in implementing targeted therapy for NSCLC.Keywords: NSCLC, CNTs, drug delivery, antitumor, carcinogenic
