Cited by 268Nanoparticle-Based Drug DeliveryNanoplatforms for cancer theranosticsDrug Transport and Resistance Mechanisms

Strategies to enhance drug delivery to solid tumors by harnessing the EPR effects and alternative targeting mechanisms

Zi, Yixuan, Yang, Kaiyun, He, Jianhua, Wu, Zimei, Liu, Jianping, Zhang, Wenli·2022·Advanced Drug Delivery Reviews

Abstract

The Enhanced Permeability and Retention (EPR) effect has been recognized as the central paradigm in tumor-targeted delivery in the last decades. In the wake of this concept, nanotechnologies have reached phenomenal levels in research. However, clinical tumors display a poor manifestation of EPR effect. Factors including tumor heterogeneity, complicating tumor microenvironment, and discrepancies between laboratory models and human tumors largely contribute to poor efficiency in tumor-targeted delivery and therapeutic failure in clinical translation. In this article, approaches for evaluation of EPR effect in human tumor were overviewed as guidance to employ EPR effect for cancer treatment. Strategies to augment EPR-mediated tumoral delivery are discussed in different dimensions including enhancement of vascular permeability, depletion of tumor extracellular matrix and optimization of nanoparticle design. Besides, the recent development in alternative tumor-targeted delivery mechanisms are highlighted including transendothelial pathway, endogenous cell carriers and non-immunogenic bacteria-mediated delivery. In addition, the emerging preclinical models better reflect human tumors are introduced. Finally, more rational applications of EPR effect in other disease and field are proposed. This article elaborates on fundamental reasons for the gaps between theoretical expectation and clinical outcomes, attempting to provide some perspective directions for future development of cancer nanomedicines in this still evolving landscape.

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Crossref · 10.1016/j.addr.2022.114449

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  • Another option is to augment tumoral retention via ECM modulation, including direct depletion of ECM components, inhibition of synthesis of ECM components, or modulation of ECM-associated cells.

    “Another option is to augment tumoral retention via ECM modulation. This strategy includes direct depletion of ECM components, inhibition of the synthesis of ECM components, or modulation of ECM-associated cells [156].”

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Authors
Zi, Y., Yang, K., He, J., Wu, Z., Liu, J., & Zhang, W.
Affiliations
  • China Pharmaceutical University (CN)
  • University of Auckland (NZ)
Corresponding author
  • Wu, Zimei
  • Liu, Jianping
  • Zhang, Wenli
Venue
Advanced Drug Delivery Reviews
Publisher
Elsevier BV
Published
2022-09
Volume
188
Pages
114449
ISSN
0169-409X (ISSN-L)
OpenAlex
W4285012964
Cited by
268
References
214
Citations by year
2026: 62 · 2025: 89 · 2024: 66 · 2023: 44 · 2022: 7
FWCI
3.55
Type
journal article
Language
en
Open access
closed
Locations
  • Advanced Drug Delivery Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion)
Funders
  • Six Talent Climax Foundation of Jiangsu (SWYY-106)
  • Six Talent Peaks Project in Jiangsu Province
  • National Major Science and Technology Projects of China (2017YFA0205400)
Topics
  • Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
  • Physical Sciences › Engineering › Biomedical Engineering › Nanoplatforms for cancer theranostics
  • Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
Keywords
enhanced permeability and retention effect, solid tumors, anticancer drug delivery, cancer nanomedicine, tumor vascular permeability, tumor extracellular matrix, nanoparticle design, tumor microenvironment, tumor heterogeneity, preclinical cancer models, clinical translation
MeSH terms
Antineoplastic Agents, Humans, Neoplasms, Permeability, Drug Delivery Systems, Nanomedicine, Nanoparticles, Tumor Microenvironment

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