Dual Targeting Drug Delivery for Cancer Theranostics

Over recent years, theranostic nanosystems have emerged as promising tools in cancer therapy and diagnostics. Active-targeted theranostic nanosystems are based on developing a nanocarrier modified with ligands or particular physical or chemical characteristics for specifically bind to surface markers of cancer cells and deliver therapeutic imaging and diagnostic agent or all of them to specific cancer cells and even organelles, providing personalized treatment for different tumors and patients. To now, different ligands were used to active targeting of nanocarriers. Antibodies, aptamers, transferrin, folic acid, and arginine-glycine-aspartic acid tripeptide are of the most studied ligands used for active targeting. Cancerous cells can internalize these systems by receptor-mediated endocytosis. However, therapeutic efficacy of single-targeted developed drug delivery systems is not yet satisfactory for clinical use because of the tumors complex microenvironment. To address mentioned challenge, dual and multi-targeted therapies have developed recently and demonstrate superior efficacy over single targeting in terms of cellular uptake, cell selectivity, and penetration into the tumor. Several dual-targeted nanocarriers introduced for cancer theranostic mainly belong to lipid-, polymer-, and carbon-based carriers. Herein, an overview of various developed dual-targeted nanomedicines used for cancer targeted theranostic will be reviewed; also challenges and outlook in designing dual-targeted nanomedicines will be discussed. Although these studies are only conducted in vitro and in vivo, in the upcoming years, it is highly likely that this field of treatment and diagnostics will be used in the clinical stage and help better treatment of rare diseases including cancer.