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Chitosan-Based Drug Delivery Systems for Targeted Chemotherapy in Colorectal Cancer: A Scoping Review

Open access

Abstract

Chitosan (CS) has emerged as a versatile biopolymer for designing drug delivery systems (DDS) in colorectal cancer (CRC) therapy due to its biocompatibility, mucoadhesive properties, and ability to be surface-functionalized. This scoping review systematically analyzed current experimental studies on CS-based DDS for CRC, comparing non-targeted formulations with ligand-modified systems to identify advances in targeting efficiency, drug release behavior, and biological outcomes. Among the twenty-five initially identified studies, divided into two categories, non-targeted CS-based DDSs and ligand-modified CS-DDSs, five fulfilled the inclusion criteria for ligand-functionalized systems. These incorporated targeting moieties, such as folic acid (FA), hyaluronic acid (HA), and galactose (Gal), to achieve receptor-mediated uptake via FRα, CD44, and ASGP receptors, respectively. Ligand modification consistently enhanced cellular uptake, reduced IC50 values, and improved tumor-selective cytotoxicity compared to non-targeted systems. However, in vivo validation remains scarce, with only one study confirming tumor accumulation in xenograft models. Moreover, no clinical trials currently assess CS-based nanocarriers for the treatment of CRC. Overall, CS represents a promising modular platform for targeted nanomedicine, but translational progress requires bridging preclinical success with comprehensive in vivo and clinical evaluation.

Verified 2026-11-10 · 2 references not checked yet

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review maps 25 original studies on chitosan-based drug delivery systems for colorectal cancer, comparing non-targeted and ligand-modified formulations. Ligand modification with folate, hyaluronic acid, or galactose improved uptake and cytotoxicity in vitro, but in vivo and clinical evidence remains scarce.

Key findings

  • Of 25 included original studies, 20 were non-targeted chitosan-based DDS and 5 met criteria for ligand-modified active targeting; the ligands were folic acid, hyaluronic acid, and galactose, targeting FRα, CD44, and ASGPR, respectively.
  • Ligand-modified systems showed up to a 1.5–3-fold increase in cellular uptake in FRα+ and CD44+ colorectal cancer cells and reduced IC50 values by 40–70% relative to non-functionalized chitosan carriers; only one study demonstrated tumor accumulation in xenograft models.
  • Non-targeted systems included 15 oral colon-directed formulations across eight studies and 13 intravenously administered DDS across 12 studies; examples include PEG-OA-modified chitosan micelles reducing tumor volume by 50%, charge-reversal Oxa-R-NGs achieving 77% oxaliplatin release under tumor-mimicking pH with ultrasound, capecitabine-loaded chitosan NPs producing approximately 72% tumor reduction within 21 days, and SN-38 chitosan systems with *Bifidobacterium bifidum* achieving approximately 80% tumor suppression.
  • No clinical trials directly evaluate chitosan-based nanocarriers for colorectal cancer; registered chitosan cancer trials focus on supportive, surgical, or topical applications rather than systemic anticancer drug delivery.

Methods

  • Scoping review conducted according to PRISMA-ScR, using PubMed searches limited to original research articles in English published January 2020–June 2025, with two complementary search strategies: a broad MeSH-based query and a ligand-targeted Title/Abstract search.
  • Inclusion required a chitosan-based DDS for colorectal cancer, a chemotherapeutic payload, and experimental in vitro and/or in vivo biological evaluation; exclusions included non-CRC studies, no chitosan, no chemotherapeutic agent, no biological results, reviews, book chapters, and non-English papers.
  • Screening and data extraction were performed by four independent reviewers, with discrepancies resolved by a fifth reviewer; extracted data covered DDS composition, ligands, drug, release methodology, cytotoxicity, animal models, and biological effects, and studies were categorized as non-targeted or ligand-modified.

Limitations

  • The paper states that in vivo validation is scarce, with only one study confirming tumor accumulation in xenograft models and no clinical trials of chitosan-based nanocarriers for CRC; most studies used 2D monolayer models, pharmacokinetic and immunogenicity data were underreported, chitosan materials were heterogeneous, methods were not standardized, and in vivo work relied on immunocompromised xenograft models. It also notes receptor heterogeneity, binding-site barrier effects, variable ligand density, lack of ligand-density optimization or saturation kinetics, short-duration studies with unclear sample sizes, and frequent lack of appropriate comparator groups.
  • Evident from the text: as a scoping review, it does not report a quantitative meta-analysis or formal risk-of-bias assessment, and the search was restricted to PubMed, English-language, 2020–2025 publications, which may omit relevant non-English or older studies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/md23120467

Cites

94 of 96 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1 Chemical structure of chitosan.
Figure 1 Chemical structure of chitosan.CC BY · PubMed Central
Figure 2 Flowchart showing the classification of the 25 included studies into non-targeted and ligand-modified CS-based DDSs.
Figure 2 Flowchart showing the classification of the 25 included studies into non-targeted and ligand-modified CS-based DDSs.CC BY · PubMed Central
Figure 3 Receptor-mediated endocytosis in colorectal cancer cells via FRα, CD44, and ASGP receptors, showing ligand binding preferences and internalization pathways.
Figure 3 Receptor-mediated endocytosis in colorectal cancer cells via FRα, CD44, and ASGP receptors, showing ligand binding preferences and internalization pathways.CC BY · PubMed Central
Figure 4 Schematic representation of FRα-mediated internalization of folate-targeted CS-based DDSs. FA on the nanocarrier surface binds to overexpressed folate receptors on CRC cells, triggering receptor-mediated endocytosis and facilitating intracellular delivery of the encapsulated drug.
Figure 4 Schematic representation of FRα-mediated internalization of folate-targeted CS-based DDSs. FA on the nanocarrier surface binds to overexpressed folate receptors on CRC cells, triggering receptor-mediated endocytosis and facilitating intracellular delivery of the encapsulated drug.CC BY · PubMed Central
Figure 5 PRISMA 2020 flow diagram detailing the identification, screening and inclusion stages for studies investigating chitosan-based drug delivery systems for colorectal cancer. Diagram generated using the PRISMA2020 R package and the PRISMA Shiny app [96].
Figure 5 PRISMA 2020 flow diagram detailing the identification, screening and inclusion stages for studies investigating chitosan-based drug delivery systems for colorectal cancer. Diagram generated using the PRISMA2020 R package and the PRISMA Shiny app [96].CC BY · PubMed Central
Figure 6 PRISMA 2020 flow diagram illustrating the identification, screening, and inclusion process for ligand-modified chitosan-based drug delivery systems for colorectal cancer. Diagram generated using the PRISMA2020 R package and the PRISMA Shiny app [96].
Figure 6 PRISMA 2020 flow diagram illustrating the identification, screening, and inclusion process for ligand-modified chitosan-based drug delivery systems for colorectal cancer. Diagram generated using the PRISMA2020 R package and the PRISMA Shiny app [96].CC BY · PubMed Central

Verification

Claims the paper makes

29 No basis given · 23 Own interpretation · 11 Not checked yet · 9 Own result · 6 No full text of the sources · 1 Couldn’t confirm · 1 Own method · accuracy not yet measured

Verify all 10 references — free account
  • It may state two separate claims as one. 43
  • The quote only partly states this claim. 5
  • Probably not a substantial claim. 4
47 of 47
  • The paper relies on this without support.

    Chitosan is non-toxic, biodegradable, biocompatible, low-immunogenicity, mucoadhesive, and absorption-enhancing.

    “CS is a non-toxic, biodegradable polymer characterized by high biocompatibility, low immunogenicity, and mucoadhesive as well as absorption-enhancing properties.”
  • The paper relies on this without support.

    Chitosan-based DDS are being developed as targeted therapies employing ligands such as folic acid, hyaluronic acid, galactose, and antisense oligonucleotides, which enable receptor-specific interactions with the folate receptor, CD44, and the asialoglycoprotein receptor.

    “Importantly, these systems are also being developed as targeted therapies employing a range of common ligands, such as folic acid (FA), hyaluronic acid (HA), galactose (Gal), and antisense oligonucleotides, which enable receptor-specific interactions with the folate receptor (FR), CD44, and the asialoglycoprotein receptor (ASGPR).”
2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

2 of 2

Citations

Cites

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Cited by

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Metadata

Authors
Piotrowska, U., Szatko, J., Nowakowska, A., Klimaszewska, E., Ogorzałek, M., & Sobczak, M.
Affiliations
  • Medical University of Warsaw (PL)
  • Department of Cosmetology, Faculty of Medical Sciences and Health Sciences, Casimir Pulaski University of Radom, 27 Chrobrego Str., 26-600 Radom, Poland
Corresponding author
Piotrowska, Urszula
Venue
Marine Drugs
Publisher
MDPI AG
Published
2025-12-06
Volume
23
Issue
12
Pages
467
ISSN
1660-3397 (ISSN-L)
OpenAlex
W4417113590
Cited by
14
References
94
Citations by year
2026: 14
FWCI
0.69
Type
journal article
Language
en
Open access
Locations
  • Marine Drugs (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Science Centre, Poland (2022/47/D/NZ7/01403)
Topics
  • Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Interference and Gene Delivery
Keywords
chitosan, drug delivery systems, colorectal cancer, targeted chemotherapy, folic acid, hyaluronic acid, galactose, folate receptor alpha, CD44, mucoadhesion, tumor targeting, drug release, nanomedicine
MeSH terms
Animals, Antineoplastic Agents, Drug Carriers, Humans, Hyaluronic Acid, Colorectal Neoplasms, Drug Delivery Systems, Chitosan, Drug Liberation

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