title: Are nanotheranostics and nanodiagnostics-guided drug delivery stepping stones towards precision medicine?
abstract: The progress in medical research has led to the understanding that cancer is a large group of heterogeneous diseases, with high variability between and within individuals. This variability sprouted the ambitious goal to improve therapeutic outcomes, while minimizing drug adverse effects through stratification of patients by the differences in their disease markers, in a personalized manner, as opposed to the strategy of "one therapy fits all". Nanotheranostics, composed of nanoparticles (NPs) carrying therapeutic and/or diagnostics probes, have the potential to revolutionize personalized medicine. There are different modalities to combine these two distinct fields into one system for a synergistic outcome. The addition of a nanocarrier to a theranostic system holds great promise. Nanocarriers possess high surface area, enabling sophisticated functionalization with imaging agents, thus gaining enhanced diagnostic ability in real-time. Yet, most of the FDA-approved theranostic approaches are based on small molecules. The theranostic approaches that are reviewed herein are paving the road towards personalized medicine through all stages of patient care: starting from screening and diagnostics, proceeding to treatment and ending with treatment follow-up. Our current review provides a broad background and highlights new insights for the rational design of theranostic nanosystems for desired therapeutic niches, while summoning the hurdles on their way to become first-line diagnostics and therapeutics for cancer patients.
authors.affiliation: Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Rachel
authors.initials: R
authors.lastname: Blau
authors.affiliation: Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Adva
authors.initials: A
authors.lastname: Krivitsky
authors.affiliation: Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yana
authors.initials: Y
authors.lastname: Epshtein
authors.affiliation: Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ronitsf@post.tau.ac.il.
authors.forename: Ronit
authors.initials: R
authors.lastname: Satchi-Fainaro
mesh_terms: D002986:Clinical Trials as Topic; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods*; D016503:Drug Delivery Systems / Q000379:methods*; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods; D006801:Humans; D045423:Microbubbles / Q000627:therapeutic use; D053758:Nanoparticles / Q000008:administration & dosage; D009367:Neoplasm Staging; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D010778:Photochemotherapy / Q000379:methods; D057285:Precision Medicine / Q000295:instrumentation / Q000379:methods*; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D061089:Radiotherapy, Image-Guided / Q000379:methods; D000068936:Theranostic Nanomedicine / Q000295:instrumentation / Q000379:methods*
chemical_list: D011838:Radiation-Sensitizing Agents
keywords: Fluorescence real-time imaging; Image-guided surgery; Molecular imaging; Polymeric nanoparticles; Precision medicine; Theranostics