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Advances in Radiotherapy
& Nuclear Medicine Nanomaterials in cancer chemoimmunotherapy

ability to kill cancer cells while minimizing systemic such as poor pharmacokinetics and the development of
toxicity. Commonly used therapeutic antibodies include multiple drug resistance. As a result, chemotherapy is
monoclonal antibodies such as programmed death 1 (PD- often combined with other therapeutic techniques, such
1) antibodies and programmed death ligand-1 (PD-L1) as radiotherapy, surgical treatment, and immunotherapy,
antibodies. Numerous monoclonal antibodies have been to enhance its efficacy. Among these combinations, the
17
approved by the FDA and are currently used in cancer integration of chemotherapy with immunotherapy –
treatment. For instance, Rituximab (the first anti-B- termed chemoimmunotherapy – has emerged as a potent
lymphocyte antigen monoclonal antibody) is used to treat synergistic strategy for improving antitumor efficacy, and
blood cancers, Trastuzumab (an anti-human epidermal numerous products are currently undergoing pre-clinical
growth factor receptor 2 monoclonal antibody) is used in and clinical trials.
the treatment of breast cancer, and Cetuximab (an anti-
epidermal growth factor receptor monoclonal antibody) Chemotherapeutic drugs are expected to induce
is used to treat metastatic colorectal cancer. Monoclonal immunomodulation within the tumor microenvironment,
antibodies can be used alone or in combination with other primarily by triggering immunogenic tumor cell death,
anticancer agents. For instance, Kadcyla, an FDA and inhibiting the expression of immune checkpoints,
European Medicines Agency-approved antibody-drug maintaining the suppressive influence of T cells,
conjugate comprising Trastuzumab and the chemotherapy promoting the infiltration of tumor-killing cells, enhancing
drug Emtansine is used to treat metastatic breast cancer. 18 intrinsic tumor cell immunogenicity, downregulating
the immunosuppressive microenvironment, and
2.4. Cytokine therapy influencing the function of other cells, such as dendritic
7,21
Cytokines are chemical messengers or signaling proteins cells and myeloid-derived suppressor cells. Although
in the immune system. These small, soluble proteins chemoimmunotherapy holds significant potential for
are released by various cells, such as T cells, mast cells, tumor management and reducing recurrence rates,
B cells, and macrophages. Cytokines can improve the conventional dosing methods may reduce its effectiveness
8
patient’s immune response either by directly inducing due to inadequate accumulation, low circulation time,
apoptosis through pro-apoptotic and anti-proliferative induction of toxicity, and insufficient infiltration in tumor
signals or indirectly by activating cytotoxic immune cells, tissues under physiological conditions. In this regard,
thereby eradicating cancer cells. Numerous cytokines nanotechnology has emerged as a promising tool to
have been studied and applied in cancer therapy to date, address several of these challenges by lowering drug doses
including interferons, tumor necrosis factor, interleukins, and reducing the frequency of administration, leading to
and granulocyte-macrophage colony-stimulating factor. safer chemoimmunotherapy treatments. In recent decades,
Interferon alpha was the first cytokine approved by the the application of multifunctional nanomaterial-assisted
19
FDA for leukemia cancer immunotherapy in 1986. It drug delivery systems has become increasingly popular
was later used for treating lymphoma, melanoma, and in chemoimmunotherapy due to their adjustability and
®
AIDS-related Kaposi’s sarcoma. Aldesleukin (Proleukin ), versatility, thereby helping to resolve various cancer-
a synthetic interleukin, was approved for the treatment of related issues.
melanoma and kidney cancer. 20
4. Nanomaterial-assisted drug delivery
Although immunotherapy offers significant advantages
in cancer treatment, it faces certain challenges in some systems
patients or tumor types, including weak immunogenicity of Nanomaterials have been increasingly adopted in
therapeutic vaccines, off-target side effects, and immune- chemoimmunotherapy due to their significant advantages,
related adverse events. including multi-drug co-delivery, precise targeting,
controlled drug release, promotion of immune responses,
3. Cancer chemoimmunotherapy and sensitivity to stimuli (such as pH, redox, enzymes, heat,

Chemotherapy is one of the most commonly used magnetic fields, and light). These nanomaterials improve
traditional approaches for cancer treatment, utilizing toxic the stability, solubility, bioavailability, and circulation
compounds to inhibit the proliferation of rapidly growing time of drugs, thereby enhancing their pharmacokinetic
cancer cells. However, these chemotherapy drugs also affect properties in vivo. As a result, they increase therapeutic
other fast-growing healthy cells, such as those in the bone effects while minimizing toxic side effects. Furthermore,
marrow, hair follicles, and gastrointestinal tract, leading they offer the advantages, such as facile synthesis, cost-
to toxic side effects, such as severe nausea, hair loss, and efficiency, and scalability for large-scale production.
bowel issues. In addition, chemotherapy faces challenges Numerous nanomaterial-assisted drug delivery systems

Volume 3 Issue 1 (2025) 85 doi: 10.36922/arnm.8150