Conventional tumor-targeted drug delivery systems(DDSs)face challenges,such as unsatisfied systemic circulation,low targeting efficiency,poor tumoral penetration,and uncontrolled drug release.Recently,tumor cellular m...Conventional tumor-targeted drug delivery systems(DDSs)face challenges,such as unsatisfied systemic circulation,low targeting efficiency,poor tumoral penetration,and uncontrolled drug release.Recently,tumor cellular molecules-triggered DDSs have aroused great interests in addressing such dilemmas.With the introduction of several additional functionalities,the properties of these smart DDSs including size,surface charge and ligand exposure can response to different tumor microenvironments for a more efficient tumor targeting,and eventually achieve desired drug release for an optimized therapeutic efficiency.This review highlights the recent research progresses on smart tumor environment responsive drug delivery systems for targeted drug delivery.Dynamic targeting strategies and functional moieties sensitive to a variety of tumor cellular stimuli,including pH,glutathione,adenosine-triphosphate,reactive oxygen species,enzyme and inflammatory factors are summarized.Special emphasis of this review is placed on their responsive mechanisms,drug loading models,drawbacks and merits.Several typical multi-stimuli responsive DDSs are listed.And the main challenges and potential future development are discussed.展开更多
Objective: Breast cancer in young females was usually considered more aggressive and requires aggressive therapy. We investigated whether early detection and improved treatments changed the patterns of characteristics...Objective: Breast cancer in young females was usually considered more aggressive and requires aggressive therapy. We investigated whether early detection and improved treatments changed the patterns of characteristics,management and outcomes of young breast cancer patients over time.Methods: Females under 40 years of age diagnosed with breast cancer during the periods 1999-2017 and1999-2015 were identified in the Fudan University Shanghai Cancer Center(FUSCC) and the population-based Surveillance, Epidemiology, and End Results(SEER) registry, respectively. Clinicopathologic characteristics and treatment information were collected. Patients diagnosed before 2013 were followed up.Results: The proportions of young breast cancer patients were 15.0% and 5.3% in the FUSCC and SEER cohorts, respectively. In the FUSCC cohort, there was a significant increase in the proportion of ductal carcinoma in situ(DCIS)(from 8.8% to 16.9%;P<0.0001) and it remained stable in SEER cohort. The proportion of T1-stage tumors increased dramatically in the FUSCC cohort(from 35.3% to 41.9%;P=0.008), whereas it decreased in SEER cohort(from 42.4% to 33.0%;P<0.0001). The percentage of estrogen receptor(ER)-positive cancers was consistently increased in both the invasive ductal carcinoma(IDC) and DCIS patients in the two cohorts. Breastconserving surgery and immediate implant reconstruction after mastectomy both exhibited increased use over time in the FUSCC cohort. Both the FUSCC and SEER cohorts showed a significantly better prognosis in the recent time period.Conclusions: With the increased early-stage and ER-positive diseases in young patients as well as better systemic treatment strategies, improved survival has been observed in recent years. There has been a substantial deescalation in surgical therapies in young breast cancer patients.展开更多
Breast cancer is the most common malignant tumor in Chinese women,and its incidence is increasing.Regular screening is an effective method for early tumor detection and improving patient prognosis.In this review,we an...Breast cancer is the most common malignant tumor in Chinese women,and its incidence is increasing.Regular screening is an effective method for early tumor detection and improving patient prognosis.In this review,we analyze the epidemiological changes and risk factors associated with breast cancer in China and describe the establishment of a screening strategy suitable for Chinese women.Chinese patients with breast cancer tend to be younger than Western patients and to have denser breasts.Therefore,the age of initial screening in Chinese women should be earlier,and the importance of screening with a combination of ultrasound and mammography is stressed.Moreover,Chinese patients with breast cancers have several ancestry-specific genetic features,and aiding in the determination of genetic screening strategies for identifying high-risk populations.On the basis of current studies,we summarize the development of risk-stratified breast cancer screening guidelines for Chinese women and describe the significant improvement in the prognosis of patients with breast cancer in China.展开更多
基金Supported by the Huxiang Young Talent Program of Hunan Province(2018RS3005)The Project of Innovation-driven Plan in Central South University(2020CX048)+3 种基金Hunan Provincial Natural Science Foundation of China(2019JJ60071,2020JJ4680)the Shenghua Yuying Project of Central South University,the Hunan Provincial Postgraduate Research and Innovation Project(CX20190242)Postgraduate Independent Exploration and Innovation Project of Central South University(2019zzts1017,2019zzts750)the Key Research Fund of Hunan Provincial Education Department(18A211).
文摘Conventional tumor-targeted drug delivery systems(DDSs)face challenges,such as unsatisfied systemic circulation,low targeting efficiency,poor tumoral penetration,and uncontrolled drug release.Recently,tumor cellular molecules-triggered DDSs have aroused great interests in addressing such dilemmas.With the introduction of several additional functionalities,the properties of these smart DDSs including size,surface charge and ligand exposure can response to different tumor microenvironments for a more efficient tumor targeting,and eventually achieve desired drug release for an optimized therapeutic efficiency.This review highlights the recent research progresses on smart tumor environment responsive drug delivery systems for targeted drug delivery.Dynamic targeting strategies and functional moieties sensitive to a variety of tumor cellular stimuli,including pH,glutathione,adenosine-triphosphate,reactive oxygen species,enzyme and inflammatory factors are summarized.Special emphasis of this review is placed on their responsive mechanisms,drug loading models,drawbacks and merits.Several typical multi-stimuli responsive DDSs are listed.And the main challenges and potential future development are discussed.
基金supported in part by grants from the Shenkang center city hospital emerging frontier technology joint research project (No. SHDC12015119)National Key R&D Program of China (No. 2017YFC1311004)
文摘Objective: Breast cancer in young females was usually considered more aggressive and requires aggressive therapy. We investigated whether early detection and improved treatments changed the patterns of characteristics,management and outcomes of young breast cancer patients over time.Methods: Females under 40 years of age diagnosed with breast cancer during the periods 1999-2017 and1999-2015 were identified in the Fudan University Shanghai Cancer Center(FUSCC) and the population-based Surveillance, Epidemiology, and End Results(SEER) registry, respectively. Clinicopathologic characteristics and treatment information were collected. Patients diagnosed before 2013 were followed up.Results: The proportions of young breast cancer patients were 15.0% and 5.3% in the FUSCC and SEER cohorts, respectively. In the FUSCC cohort, there was a significant increase in the proportion of ductal carcinoma in situ(DCIS)(from 8.8% to 16.9%;P<0.0001) and it remained stable in SEER cohort. The proportion of T1-stage tumors increased dramatically in the FUSCC cohort(from 35.3% to 41.9%;P=0.008), whereas it decreased in SEER cohort(from 42.4% to 33.0%;P<0.0001). The percentage of estrogen receptor(ER)-positive cancers was consistently increased in both the invasive ductal carcinoma(IDC) and DCIS patients in the two cohorts. Breastconserving surgery and immediate implant reconstruction after mastectomy both exhibited increased use over time in the FUSCC cohort. Both the FUSCC and SEER cohorts showed a significantly better prognosis in the recent time period.Conclusions: With the increased early-stage and ER-positive diseases in young patients as well as better systemic treatment strategies, improved survival has been observed in recent years. There has been a substantial deescalation in surgical therapies in young breast cancer patients.
基金This work was supported by Grants from the National Key R&D Project of China(Grant No.2020YFA0112304)the National Natural Science Foundation of China(Grant Nos.91959207,92159301 and 82002792)+3 种基金the Shanghai Key Laboratory of Breast Cancer(Grant No.12DZ2260100)the Shanghai Key Clinical Specialty of Oncology(Grant No.shslczdzk02001)the Clinical Research Plan of SHDC(Grant Nos.SHDC2020CR4002 and SHDC2020CR5005)the Shanghai Sailing Program(Grant No.20YF1408600).
文摘Breast cancer is the most common malignant tumor in Chinese women,and its incidence is increasing.Regular screening is an effective method for early tumor detection and improving patient prognosis.In this review,we analyze the epidemiological changes and risk factors associated with breast cancer in China and describe the establishment of a screening strategy suitable for Chinese women.Chinese patients with breast cancer tend to be younger than Western patients and to have denser breasts.Therefore,the age of initial screening in Chinese women should be earlier,and the importance of screening with a combination of ultrasound and mammography is stressed.Moreover,Chinese patients with breast cancers have several ancestry-specific genetic features,and aiding in the determination of genetic screening strategies for identifying high-risk populations.On the basis of current studies,we summarize the development of risk-stratified breast cancer screening guidelines for Chinese women and describe the significant improvement in the prognosis of patients with breast cancer in China.
