Brief introduction of nanomedicines currently used in domestic clinics

At present, there are dozens of nanodrug delivery systems (“nanodrugs”) that have been approved for application or have entered clinical trials at home and abroad. However, some of them are not yet approved for clinical use, some are not yet available in China, and some are not used for antitumor treatment (e.g., amphotericin liposomes, etc.). The following is a brief introduction to the nanomedicines in the field of tumor treatment that have been put into use in China: 1. Goserelin extended release implant: the trade name “Noraid” is gonadotropin-releasing hormone goserelin loaded with polylactic acid-hydroxyacetic acid copolymer (PLGA) to make it achieve the effect of extended release. With one injection, the therapeutic effect can last for one month, which greatly reduces the pain of patients and is easy to use. It is widely used for hormone therapy of breast cancer and prostate cancer. At present, it has entered the medical insurance of Nanjing. 2. Liposome of Paclitaxel: the trade name is “Liposol”, which is a liposome loading of common antitumor drug Paclitaxel, which can increase the efficacy and reduce the toxicity and adverse reaction rate to a certain extent. Currently, it has entered the medical insurance of Nanjing. 3. Albumin-bound paclitaxel: trade name “Abraxane”, which is loaded with paclitaxel by albumin nanoparticles. This dosage form uses biomolecules to load the drug, which can significantly reduce the adverse effects of paclitaxel. Usually, before using paclitaxel, patients have to take a lot of hormones orally and receive injections in advance to prevent allergic reactions. In contrast, Abraxane is safe because it does not require the application of anti-allergic drugs. In addition, Abraxane also improves the efficacy to a certain extent, especially in squamous cell carcinoma (a pathological type of tumor), where Abraxane shows particular advantages. Currently, the drug is also covered by health insurance. 4. Liposomal Adriamycin: Trade name “Kale”, “Ribotoxin”. Adriamycin is loaded with liposomes. Adriamycin is the most commonly used drug for breast cancer and other tumors, but it has obvious side effects, especially severe hair loss, vomiting and cardiotoxicity, which are daunting to many patients. Liposomal adriamycin can improve the efficacy of regular adriamycin to some extent and reduce its adverse effects, especially its cardiotoxicity. 5.Long-acting G-CSF: trade name “Lonquex”, “Zingyouli”. Most of the patients will have different degrees of granulocytopenia during the treatment process. Injections of G-CSF (scientific name: G-CSF) are required. However, these injections need to be given every day, and in cases of severe granulocytopenia, the injections may be given for more than 10 days. Long-acting G-CSF, on the other hand, is a polymer attached to G-CSF: PEG, which acts as a soft “arm” to maintain its effect for a significantly longer period of time, and can be given once per chemotherapy cycle. This greatly reduces the patient’s pain and is very convenient. 6. Fluorouracil extended-release implant: trade name “Zhongren Fluoran”. It is a commonly used antitumor drug fluorouracil loaded with polymer material polylactic acid to achieve the effect of slow release of drug. It is usually used locally during surgery. These nano drugs have made significant progress compared with traditional drug dosage forms. However, several issues should be noted when applying them: 1. Indications: Nanomedicines are not necessarily better than traditional dosage forms in all cases. Accordingly, the scope of reimbursement for nanomedicines that enter medical insurance is selective. The application of these nanomedicines must be under the guidance of medical oncologists. 2. cost: the price of nanomedicines is usually higher than that of conventional dosage forms, so when using them, it is necessary to integrate the patient’s condition and economic situation and apply them reasonably. 3. In addition, nanomedicines often have high requirements for preparation and other steps, and require more mature experience in medication.