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Progress in Chemistry 2023, Vol. 35 Issue (8): 1123-1135 DOI: 10.7536/PC230114   Next Articles

• Review •

Combination Antitumor Therapy Based on Codelivery Nanosystems of Doxorubicin

Yuhan Bao, Zifeng Guo, Jintao Li, Mingzu Zhang, Jinlin He(), Peihong Ni   

  1. College of Chemistry, Chemical Engineering and Materials Science, State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, Jiangsu Key Laboratory of Advanced Functional Polymer Design and Application, Suzhou Key Laboratory of Macromolecular Design and Precision Synthesis, Soochow University,Suzhou 215123, China
  • Received: Revised: Online: Published:
  • Contact: *e-mail: jlhe@suda.edu.cn
  • About author:
    †These authors contributed equally.
  • Supported by:
    Natural Science Foundation of the Jiangsu Higher Education Institutions of China(20KJA150009); Undergraduate Training Program for Innovation and Entrepreneurship, Soochow University(202110285025Z)
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Tumor has been one of the most common causes of death worldwide, while chemotherapy is still the major tool for antitumor treatment. As a broad-spectrum anthracycline-type antitumor drug, doxorubicin (DOX) has been widely used in different types of tumors in clinical practices. Nevertheless, its serious side effects, including cumulative cardiotoxicity and dose-limiting myelosuppression, present significant challenges to the clinical application. Researchers have long been committed to finding routes to reduce the toxic side effects of DOX, whereas the strategies of combination antitumor therapies based on codelivery nanosystems have received wide attention. They can realize the targeted enrichment and on-demand release of drugs in the lesion area, reducing the adverse reaction of DOX to normal tissues through drug combination and reversing the multi-drug resistance (MDR) of tumor cells to a certain extent. In this review, we focus on the recent progress on the DOX-based combination antitumor therapies together with other chemotherapeutic agents (camptothecin, paclitaxel, cisplatin), genetic drugs (pDNA, siRNA, miRNA), gas molecules (NO, O2, CO, H2S, SO2) or natural medicines (dexrazoxane, berberine, flavonoids). Besides, the current challenges and future trends of DOX-based combination therapies are also prospected.

Contents

1 Introduction

2 Combination therapy of DOX with other chemotherapeutic agents

3 Combination therapy of DOX with genetic drugs

4 Combination therapy of DOX with gas molecules

4.1 DOX in combination with NO

4.2 DOX in combination with O2

4.3 DOX in combination with CO

4.4 DOX in combination with H2S

4.5 DOX in combination with SO2

5 Combination therapy of DOX with natural medicines

6 Conclusion and outlook

Key words: doxorubicin, antitumor therapy, combination therapy, codelivery nanosystem, tumor microenvironment
Fig.1 Chemical structure and functional moieties of DOX
Fig.2 Schematic illustration of micelle structure with DOX in combination with CPT and CDDP respectively. (a) Stimuli-responsive polymer prodrug mixed micelles for co-loading DOX and CPT[26]. Copyright 2016, The Royal Society of Chemistry. (b) Self-crosslinking nanomicelles for co-loading DOX and CDDP[35]. Copyright 2018, Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim
Fig.3 Schematic illustration of DOX combined gene therapy. (a) Polyphosphate ester multifunctional carrier for the delivery of DOX and p53[48]. Copyright 2018, The Royal Society of Chemistry. (b) mPEG-PCL-g-PDMAEMA micelles co-deliver DOX and Cy5-siRNA[56]. Copyright 2016, American Chemical Society. (c) Amphiphilic containing phosphorus dendrimer micelles co-loading DOX and miR-21i[62]. Copyright 2022, The Royal Society of Chemistry. (d) lsDNA produced by TK1 mRNA, fluorescent hairpins HP and DOX self-assemble into DNA nanosphere[70]. Copyright 2020, American Chemical Society
Fig.4 Schematic illustration of DOX combined gas therapy. (a) Self-assembly and photo-triggered drug release of DOX-loading triblock copolymers of PEG-b-PNORM-b-PEG containing NO-releasing moieties within the main chain[81]. Copyright 2020, The Royal Society of Chemistry. (b) The amphiphilic molecule F-IR780-PEG co-loaded with DOX and O2 generates1O2 and releases DOX under near-infrared light irradiation[86]. Copyright 2019, The Royal Society of Chemistry. (c) Nanocarrier containing nitrophenyl ether and 3-HF derivatives loaded with DOX releases CO and DOX under illumination[95]. Copyright 2022, Multidisciplinary Digital Publishing Institute. (d) Tumor specific lipase responsive carrier loaded with DOX can release H2S through diallyl trisulfide reacting with GSH at the lesion site)[105]. Copyright 2022, Frontiers. (e) SO2-releasing amphiphilic polymeric prodrug based on pegylated poly(L-glutamate)[109]
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