Like the National Cancer Institute (NCI), we believe that nanoscience applied to cancer research is a critical approach for the elimination of cancer.
We are convinced that nanotechnology will make a significant impact on cancer diagnosis and management in potentially revolutionary ways. In vitro diagnostics used in conjunction with in vivo molecular imaging can markedly impact future cancer patient management by providing a synergy that neither strategy alone can offer. Nanotechnology can significantly advance both in vitro diagnostics through proteomic and circulating tumor cell nanosensors and in vivo diagnostics through nanoparticles for molecular imaging.
The areas of earlier cancer detection and the prediction and monitoring of response to anti-cancer therapies are both very important applications of nanotechnology with near-term clinical translational potential. The earlier detection of relevant cancers that are aggressive is a major challenge for the cancer community. Earlier intervention will greatly improve patient outcomes. If we could detect tumors as small as ~1 mm3 using multiple proteins present in the blood and verify the presence and location of the tumor with imaging, we could cost-effectively detect and manage cancer. Currently, many patients endure multiple therapeutic interventions once their cancer has been detected until a successful therapeutic regimen can be found. If methods could be developed that would allow the accurate prediction and assessment of a given individual's response to therapy, then marked improvements in cancer management would likely follow.
We now have the potential — with ultra-sensitive nanosensors — to detect relatively small tumor burdens (perhaps as small as ~1 mm3) using multiple protein biomarkers present in the blood. We also have the potential to molecularly image these early stage cancers in vivo using novel nanoparticles that allow signal amplification and multiplexing. Using nanotechnology, we should also be able to predict which patients will likely respond to a specific anti-cancer therapy and, at the same time, monitor their response to those therapies. This includes nanotechnologies that can measure changes in relevant blood proteins pre- and post-treatment as well as nanotechnologies that capture and interrogate circulating tumor cells pre- and post-therapy. In addition, molecular imaging with existing strategies (e.g., PET-CT) and novel nanoparticle-based imaging technologies can help identify the heterogeneity of tumor response at multiple metastatic sites.
Through an integrated, cohesive five-year plan that builds on our first four years of significant progress, we are pursuing the use of in vitro protein nanosensors and in vivo nanoparticles for next generation molecular imaging. As shown in Figure N1.1. above, our vision is that eventually patients will have their cancers detected at much earlier stages through blood biomarkers. Results from these blood tests will be verified by molecular imaging that will also localize the tumors prior to treatment. Post-treatment and potentially during treatment, patient response will be evaluated by blood analysis without another tumor biopsy, and via molecular imaging to ensure the accurate differentiation of responders from non-responders. To achieve this clinical potential, nanotechnology will continue to be tested in small animal models and multiple clinical trials funded through other mechanisms.