Current Cancer Therapy Reviews - Volume 16, Issue 4, 2020

Cancer is a leading cause of mortality worldwide, accounting for 8.8 million deaths in 2015. Among these, at least 0.78 million people died of liver cancer alone. The recognized risk factors for liver cancer include chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, exposure to dietary aflatoxin, fatty liver disease, alcohol-induced cirrhosis, obesity, smoking, diabetes, and iron overload. The treatment plan for early diagnosed patients includes radiation therapy, tumour ablation, surgery, immunotherapy, and chemotherapy. Some sort of drug delivery vehicles has to be used when the treatment plan is targeted chemotherapy. Nanoemulsions are a class of biphasic liquid dosage form which are mixtures of oil and water stabilized by a surfactant. They are either transparent or bluish in hue and serve as a wonderful carrier system for chemotherapeutic drugs. These vehicles have a particle size in the range of 20-200 nm allowing them to be delivered successfully in the deepest of tissues. Recent publications on nanoemulsions reveal their acceptance and a popular choice for delivering both synthetic and herbal drugs to the liver. This work focuses on some anti-cancer agents that utilized the advantages of nanoemulsion for liver cancer therapy.

Recent studies have led to a more detailed understanding of the roles played by microRNAs in health and disease, and their potential use as biomarkers in physiological and pathophysiological processes involving cancer initiation and progression. MiR-492 is encoded by a pseudogene, has a key role in some human cancer cells and its overexpression in tissues, and it has been proposed that it can be used as a good biomarker for management and early diagnosis of some cancers including breast cancer, colorectal and ovarian cancer, hepatocellular cancer, retinoblastoma and pancreatic cancer. The aim of this review was to summarize the data of MiR-492 for early diagnosis and treatment of some types of related cancers.

Hepatoblastoma (HB) is the most common primary malignant hepatic tumor of childhood and, occurring predominantly in the first two years of life. Approximately 100 cases are diagnosed every year in the United States of America. The management of HB has changed markedly over the last three decades. Alfa feto protein (AFP) and beta human chorionic gonadotrophin (beta HCG) are the main tumor markers and are markers for diagnosis and follow up. International collaborative efforts have led to the implementation of the Pre - Treatment Extent of the Disease PRETEXT staging system consensus classification to assess upfront resectability. Complete surgical resection plays a key role in successful management. Overall, outcomes have greatly improved over the past decades mainly because of advances in chemotherapy (CTR) agents and administration protocols, newer surgical approaches and liver transplantation (LT). Targeted medications towards the newly discovered β-catenin and Wnt genetic pathways in tumor cells may soon become an option for treatment. The current disease free survival (DFS) rates are approaching 85%. For the 25% of patients with metastasis at presentation, the overall survival (OS) remains poor. A more individualized approach to treating the heterogeneous spectrum of HB may become the basis of successful treatment in complex cases. Newer medications and surgical techniques are being exploited. Here we present a comprehensive review of the recent advances in the management of HB. A wide literature search was made using internet search engines such as PubMed and Google scholar. More than 100 articles were reviewed and the information extrapolated was arranged to produce this review.

Oncolytic viruses (OV) are considered as promising tools in cancer treatment. In addition to direct cytolysis, the stimulation of both innate and adaptive immune responses is the most important mechanism in oncolytic virotherapy that finally leads to the long-standing tumor retardations in the advanced melanoma clinical trials. The OVs have become a worthy method in cancer treatment, due to their several biological advantages including (1) the selective replication in cancer cells without affecting normal cells; (2) the lack of resistance to the treatment; (3) cancer stem cell targeting; (4) the ability to be spread; and (5) the immune response induction against the tumors. Numerous types of viruses; for example, Herpes simplex viruses, Adenoviruses, Reoviruses, Poliovirus, and Newcastle disease virus have been studied as a possible cancer treatment strategy. Although some viruses have a natural orientation or tropism to cancer cells, several others need attenuation and genetic manipulation to increase the safety and tumor-specific replication activity. Two important mechanisms are involved in OV antitumor responses, which include the tumor cell death due to virus replication, and also induction of immunogenic cell death as a result of the immune system responses against the tumor cells. Furthermore, the high efficiency of OV on antitumor immune response stimulation can finally lead to a significant tumor shrinkage.

Immunoliposomes have emerged as attractive drug targeting vehicles for cancer treatment. This review presents the recent advances in the design of immunoliposomes encapsulating a variety of chemotherapeutic agents. We provided an overview of different routes that can be used to conjugate antibodies to the surfaces of liposomes, as well as several examples of stimuliresponsive immunoliposome systems and their therapeutic potential for cancer treatment.

Aim: We aimed to review the drug delivery approaches including a novel drug delivery system of doxorubicin as an important anticancer drug. Background: Doxorubicin (DOX) is widely used against breast, uterine, ovarian, lung and cervical cancer. It is listed among the essential medicines by WHO and is thus a very important drug that can be used to fight against cancer. Despite its effectiveness, the use of the drug is limited due to its dose-dependent toxicity. Several studies based on the DOX have suggested the need for novel drug delivery formulations in the treatment of malignant and cancerous diseases due to its cytotoxic nature. Objective: This review focuses on the different formulations of DOX which is a useful drug in the management of cancers, but associated with toxicity thus these approaches found applicability in the reduction of its toxicity. Methods: We searched the scientific database using cancer, DOX, and different formulations as the keywords. Here in only peer-reviewed research articles collected which were useful to our current work. Results: This study is based on an examination of the recent advancements of its novel drug delivery formulations. DOX hydrochloride is the first liposomal anticancer drug, administered via the intravenous route, and also clinically approved for the treatment of lymphomas, leukemias, and solid tumors. DOX is prepared into a liposomal formulation that contains polyethylene glycol (PEG) layer around DOX containing liposome made by pegylation process. DOX also formulated in nano-formulations which is also discussed herein led to reduced toxicity and increased efficacy. Conclusion: In the review, we described the significance of DOX in the form of different delivery approaches in the management of cancers with a reduction in the associated toxicity.

Objective: The liver is the second most common site of distant metastasis from breast cancer that is usually associated with poor prognosis and low quality of life in breast cancer patients. Therefore, the primary diagnosis of liver metastatic lesions in breast cancer patients is very important. In this study, the ability of biochemical markers CA153, CEA, and ALP to be used for prognostic liver metastasis in women with breast cancer was investigated. Methods: 306 women with breast cancer recorded between 2008 and 2012 were included. Serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA-153), age, menopausal status, histologic type, tumor size and number of cancerous axillary lymph nodes in two groups of breast cancer women with liver metastases and without it were studied. To identify independent liver metastasis prognostic factors, logistic regression method was applied. Results: The independent prognostic factors of liver metastases in women with breast cancer are ALP, CEA, age, menopausal status, number of cancerous axillary lymph nodes and tumor size. Sensitivity and specificity analysis showed that CEA with a cutoff value of 1.1 was the most accurate predictive factor. Conclusion: The increase in the levels of CEA and ALP can be diagnostic markers for liver metastases from breast cancer.

Background: Hepatocellular carcinoma is the second leading cause of cancer-related deaths among other types of cancer due to lack of effective treatments and late diagnosis. Nanocarriers represent a novel method to deliver chemotherapeutic drugs, enhancing their bioavailability and stability. Methods: In the present study, we loaded gold nanoparticles (AuNPs) and titanium oxide nanoparticles (TiO2NPs) with ERL to investigate the efficiency of the formed composite in inducing apoptosis in HepG2 liver cancer cells. Cytotoxicity was assessed using MTT assay and cell phase distribution was assessed by flow cytometry along with apoptosis detection. Results: Data obtained indicated the efficiency of the formed composite to significantly induce cell death and arrest cell cycle and G2/M phase. IRF4 was downregulated after treatment with loaded ERL. Conclusion: Our data showed that loading ERL on TiO2NPs was more efficient than AuNPs. However, both nanocarriers were efficient compared with control.