Skin cancer and new treatment perspectives: A review

Novel Methacrylate-Based Multilayer Nanofilms with Incorporated FePt-Based Nanoparticles and the Anticancer Drug 5-Fluorouracil for Skin Cancer Treatment

Despite medical advances, skin-associated disorders continue to pose a unique challenge to physicians worldwide. Skin cancer is one of the most common forms of cancer, with more than one million new cases reported each year. Currently, surgical excision is its primary treatment; however, this can be impractical or even contradictory in certain situations. An interesting potential alternative could lie in topical treatment solutions. The goal of our study was to develop novel multilayer nanofilms consisting of a combination of polyhydroxyethyl methacrylate (PHEMA), polyhydroxypropyl methacrylate (PHPMA), sodium deoxycholate (NaDOC) with incorporated superparamagnetic iron–platinum nanoparticles (FePt NPs), and the potent anticancer drug (5-fluorouracil), for theranostic skin cancer treatment. All multilayer systems were prepared by spin-coating and characterised by atomic force microscopy, infrared spectroscopy, and contact angle measurement. The magnetic properties of the incorporated FePt NPs were evaluated using magnetisation measurement, while their size was determined using transmission electron microscopy (TEM). Drug release performance was tested in vitro, and formulation safety was evaluated on human-skin-derived fibroblasts. Finally, the efficacy for skin cancer treatment was tested on our own basal-cell carcinoma cell line.

Advances in the Novel Nanotechnology for the Targeted Tumor Therapy by the Transdermal Drug Delivery

Despite modern medicine advances greatly, cancer remains a serious challenge to world health for which effective methods of treatment have hardly been developed yet. However, throughout the recent years, the rapid-developing nanotechnology has provided a new outlook of cancer therapy by transdermal drug delivery. By disrupting the stratum corneum, drugs are delivered through the skin and navigated to the tumor site by drug delivery systems such as nanogels, microneedles, etc. The superiorities include the improvement of drug pharmacokinetics as well as reduced side effects. This paper reviews the reported novel development of transdermal drug delivery systems for targeted cancer therapy. Advanced techniques for penetrating the skin will be discussed as well.

Recent advances in polymer microneedles for drug transdermal delivery: Design strategies and applications

In recent years, the transdermal drug delivery based on microneedles (MNs) technology has received extensive attention, which offers a safer and painless alternative to hypodermic needle injection. They can pierce the stratum corneum and deliver drugs to the epidermis and dermis-structures of skin, showing prominent properties such as minimally invasive, bypassing first-pass metabolism, and self-administered. A range of materials have been used to fabricate MNs, such as silicon, metal, glass, and polymers. Among them, polymer MNs have gained increasing attention from pharmaceutical and cosmetic companies as one of the promising drug delivery methods. Microneedle products have recently become available on the market, and some of them are under evaluation for efficacy and safety. This paper focuses on current state of polymer MNs in the drug transdermal delivery. The materials and methods for the fabrication of polymer MNs and their drug administration are described. The recent progresses of polymer MNs for treatment of cancer, vaccine delivery, blood glucose regulation, androgenetic alopecia, obesity, tissue healing, myocardial infarction and gout are reviewed. The challenges of MNs technology are summarized and the future development trend of MNs is also prospected. This article is protected by copyright. All rights reserved.

Skin cancer, including related pathways and therapy and the role of luteolin derivatives as potential therapeutics

Cutaneous malignant melanoma is the fastest growing and the most aggressive form of skin cancer that is diagnosed. However, its incidence is relatively scarce compared to the highest mortality rate of all skin cancers. The much more common skin cancers include nonmelanoma malignant skin cancers. Moreover, over the past several decades, the frequency of all skin cancers has increased much more dynamically than that of almost any other type of cancer. Among the available therapeutic options for skin cancers, chemotherapy used immediately after the surgical intervention has been an essential element. Unfortunately, the main problem with conventional chemopreventive regimens involves the lack of response to treatment and the associated side effects. Hence, there is a need for much more effective anticancer drugs. Correspondingly, the targeted alternatives have involved phytochemicals, which are safer chemotherapeutic agents and exhibit competitive anticancer activity with high therapeutic efficacy. Among polyphenolic compounds, some flavonoids and their derivatives, which are mostly found in medicinal plants, have been demonstrated to influence the modulation of signaling pathways at each stage of the carcinogenesis process, which is also important in the context of skin cancers. Hence, this review focuses on an exhaustive overview of the therapeutic effects of luteolin and its derivatives in the treatment and prevention of skin cancers. The bioavailability and structure–activity relationships of luteolin derivatives are also discussed. This review is the first such complete account of all of the scientific reports concerning this particular group of natural compounds that target a specific area of neoplastic diseases.

Synthesis and Structural Characterization of CaO-P2O5-CaF:CuO Glasses with Antitumoral Effect on Skin Cancer Cells

Copper is one of the most used therapeutic metallic elements in biomedicine, ranging from antibacterial approaches to developing new complexes in cancer therapy. In the present investigation, we developed a novel xCuO∙(100 − x) [CaF₂∙3P₂O₅∙CaO] glass system with 0 ≤ x ≤ 16 mol% in order to determine the influence of doping on the composition structure of glasses. The samples were characterized by dissolution tests, pH measurements, Fourier-transform infrared spectroscopy (FT-IR), electron paramagnetic resonance (EPR), Scanning Electron Microscopy with energy dispersive spectroscopy (SEM-EDX) and afterward, their antitumor character was assessed. The glasses were mostly soluble in the aqueous medium, their dissolution rate being directly proportional to the increase in pH and the level of doping up to x = 8 mol%. FT-IR spectra of glass samples show the presence of all structural units characteristic to P₂O₅ in different rates and directly depending on the depolymerization process. SEM-EDX results revealed the presence of an amorphous glass structure composed of P, O, Ca, and Cu elements. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay showed strong cytotoxicity for tumoral cells A375 even in low concentrations for Cu-treatment. In contrast, the copper-free matrix (without Cu) determined a proliferative effect of over 70% viability for all concentrations used.

Progress in cancer drug delivery based on AS1411 oriented nanomaterials

Targeted cancer therapy has become one of the most important medical methods because of the spreading and metastatic nature of cancer. Based on the introduction of AS1411 and its four-chain structure, this paper reviews the research progress in cancer detection and drug delivery systems by modifying AS1411 aptamers based on graphene, mesoporous silica, silver and gold. The application of AS1411 in cancer treatment and drug delivery and the use of AS1411 as a targeting agent for the detection of cancer markers such as nucleoli were summarized from three aspects of active targeting, passive targeting and targeted nucleic acid apharmers. Although AS1411 has been withdrawn from clinical trials, the research surrounding its structural optimization is still very popular. Further progress has been made in the modification of nanoparticles loaded with TCM extracts by AS1411.

Therapeutic application of microsponges based drug delivery system

Microsponges delivery system (MDS) is highly porous, cross-linked based polymeric systems, that activates in the presence of temperature, rubbing and pH. MDS offers wide range of advantage, like controlled drug release, site-specific action, stable over a broad range of pH, poor irritation, cost effective, improved patient compliance. They can be transformed into various dosage forms like creams, gels, and lotions. MDS based system are suitable for treatment of topical disorders like acne, psoriasis, dandruff, eczema, scleroderma, hair loss, skin cancer, and other dreadful diseases. MDS application for drug delivery is not limited to topical drug delivery but also explored for oral, parenteral and pulmonary drug delivery. Microsponges were studied for colon targeting of drugs and genes. Additionally, MDS has wide application for sunscreen, cosmetics, and over the counter (OTC) products. Furthermore, MDS does not actuate any irritation, genotoxicity, immunogenicity or cytotoxicity. Therefore, this review extensively highlights about microsponges, their advantages, key factors affecting the micro-sponges' characteristics, the therapeutic application of microsponges in topical disorders, cancer, as cosmetics, recent advances in MDS and addresses the associated challenges.

Herbal products as skincare therapeutic agents against ultraviolet radiation-induced skin disorders

This paper aims to highlight the pharmacological aspects of listed herbal skincare products used for the treatment of various disorders caused due to ultraviolet radiation. The pharmacological aspects include safety and efficacy validation as per regulatory guidelines following internationally accepted scientific principles for their development of skincare products. Herbal products have always been used traditionally for the treatment of various skin ailments and have become more prevalent because of their safety and high efficacy benefits. The incorporation of synthetic molecules and chemical substances in the different medicinal and pharmaceutical formulations is the leading cause of the dermal toxicity. Therefore, the developments of herbal skincare products containing scientifically validated herbal ingredients have better acceptance, respect, and belief in the society. The listed herbal products in this review can help take forward the commercial development of skincare products for therapeutic as well as beauty care purposes from such plants.

Apoptosis Pathways Triggered by a Potent Antiproliferative Hybrid Chalcone on Human Melanoma Cells

The World Health Organization reported that approximately 324,000 new cases of melanoma skin cancer were diagnosed worldwide in 2020. The incidence of melanoma has been increasing over the past decades. Targeting apoptotic pathways is a potential therapeutic strategy in the transition to preclinical models and clinical trials. Some naturally occurring products and synthetic derivatives are apoptosis inducers and may represent a realistic option in the fight against the disease. Thus, chalcones have received considerable attention due to their potential cytotoxicity against cancer cells. We have previously reported a chalcone containing an indole and a pyridine heterocyclic rings and an α-bromoacryloylamido radical which displays potent antiproliferative activity against several tumor cell lines. In this study, we report that this chalcone is a potent apoptotic inducer for human melanoma cell lines SK-MEL-1 and MEL-HO. Cell death was associated with mitochondrial cytochrome c release and poly(ADP-ribose) polymerase cleavage and was prevented by a non-specific caspase inhibitor. Using SK-MEL-1 as a model, we found that the mechanism of cell death involves (i) the generation of reactive oxygen species, (ii) activation of the extrinsic and intrinsic apoptotic and mitogen-activated protein kinase pathways, (iii) upregulation of TRAIL, DR4 and DR5, (iv) downregulation of p21^Cip1/WAF1 and, inhibition of the NF-κB pathway.

FusionM4Net: A multi-stage multi-modal learning algorithm for multi-label skin lesion classification

Skin disease is one of the most common diseases in the world. Deep learning-based methods have achieved excellent skin lesion recognition performance, most of which are based on only dermoscopy images. In recent works that use multi-modality data (patient's meta-data, clinical images, and dermoscopy images), the methods adopt a one-stage fusion approach and only optimize the information fusion at the feature level. These methods do not use information fusion at the decision level and thus cannot fully use the data of all modalities. This work proposes a novel two-stage multi-modal learning algorithm (FusionM4Net) for multi-label skin diseases classification. At the first stage, we construct a FusionNet, which exploits and integrates the representation of clinical and dermoscopy images at the feature level, and then uses a Fusion Scheme 1 to conduct the information fusion at the decision level. At the second stage, to further incorporate the patient's meta-data, we propose a Fusion Scheme 2, which integrates the multi-label predictive information from the first stage and patient's meta-data information to train an SVM cluster. The final diagnosis is formed by the fusion of the predictions from the first and second stages. Our algorithm was evaluated on the seven-point checklist dataset, a well-established multi-modality multi-label skin disease dataset. Without using the patient's meta-data, the proposed FusionM4Net's first stage (FusionM4Net-FS) achieved an average accuracy of 75.7% for multi-classification tasks and 74.9% for diagnostic tasks, which is more accurate than other state-of-the-art methods. By further fusing the patient's meta-data at FusionM4Net's second stage (FusionM4Net-SS), the entire FusionM4Net finally boosts the average accuracy to 77.0% and the diagnostic accuracy to 78.5%, which indicates its robust and excellent classification performance on the label-imbalanced dataset. The corresponding code is available at: https://github.com/pixixiaonaogou/MLSDR.

Site-Specific Vesicular Drug Delivery System for Skin Cancer: A Novel Approach for Targeting

Skin cancer, one of the most prevalent cancers worldwide, has demonstrated an alarming increase in prevalence and mortality. Hence, it is a public health issue and a high burden of disease, contributing to the economic burden in its treatment. There are multiple treatment options available for skin cancer, ranging from chemotherapy to surgery. However, these conventional treatment modalities possess several limitations, urging the need for the development of an effective and safe treatment for skin cancer that could provide targeted drug delivery and site-specific tumor penetration and minimize unwanted systemic toxicity. Therefore, it is vital to understand the critical biological barriers involved in skin cancer therapeutics for the optimal development of the formulations. Various nanocarriers for targeted delivery of chemotherapeutic drugs have been developed and extensively studied to overcome the limitations faced by topical conventional dosage forms. A site-specific vesicular drug delivery system appears to be an attractive strategy in topical drug delivery for the treatment of skin malignancies. In this review, vesicular drug delivery systems, including liposomes, niosomes, ethosomes, and transfersomes in developing novel drug delivery for skin cancer therapeutics, are discussed. Firstly, the prevalence statistics, current treatments, and limitations of convention dosage form for skin cancer treatment are discussed. Then, the common type of nanocarriers involved in the research for skin cancer treatment are summarized. Lastly, the utilization of vesicular drug delivery systems in delivering chemotherapeutics is reviewed and discussed, along with their beneficial aspects over other nanocarriers, safety concerns, and clinical aspects against skin cancer treatment.

Bioinspired Multifunctional Cellulose Nanofibril-Based In Situ Liquid Wound Dressing for Multiple Synergistic Therapy of the Postoperative Infected Wound

A smart in situ-formed wound dressing with excellent antibacterial ability against drug-resistance bacterial, antitumor, and biofilm-eliminating activities to promote effective wound closure is highly desirable in therapeutic and clinical applications. Herein, we designed and developed a multifunctional; shape-adaptable; and pH, temperature, and near-infrared radiation (NIR) multiple responsive cellulose nanofibril (CNF)-based in situ liquid wound dressing, using a pH-sensitive CNF grafted with terminated amino hyperbranched polyamines (HBP-NH₂) as a substrate, along with poly(N-isopropylacrylamide) and indocyanine green (ICG) loaded as the temperature and NIR on/off switches, respectively. The 3D nanocage network structure of CNF and the nanocavities in the hyperbranched structure of HBP-NH₂ endow the dressing with a high loading capacity for active drugs (doxorubicin and ICG) simultaneously. Moreover, the responsiveness of the dressing to multiple stimuli enables controllable and efficient drug release to the wound area. The bioinspired dressing demonstrates excellent antibacterial activity against common bacteria and methicillin-resistant Staphylococcus aureus, antitumor activity against A375 tumor cells, and biofilm-eliminating capability. In addition, the developed dressing synergistically combines multiple therapeutic strategies for effective wound healing, specifically photothermal therapy, photodynamic therapy, and chemotherapy. The design provides an ideal clinical intervention strategy for irregular tumor postoperative infected wounds.

Cannabidiol-Mediated Green Synthesis, Characterization, and Cytotoxicity of Metal Nanoparticles in Human Keratinocyte Cells

This study investigated a unique one-pot microwave-assisted green synthesis method of gold (Au) and silver (Ag) nanoparticles (NPs) using cannabidiol (CBD) as a capping and reducing agent. Furthermore, Au and Ag NPs were also chemically synthesized using poly(vinyl pyrrolidone), which functioned as reference materials when comparing the size, shape, and cytotoxicity of NPs. Synthesis parameters such as reaction time, temperature, and precursor molar ratio were optimized to control the size and shape of the biosynthesized NPs. Various characterization techniques such as transmission electron microscopy, ultraviolet-visible spectroscopy, Fourier transform infrared spectroscopy, and X-ray diffraction were used to confirm the formation and properties of Au and Ag NPs. Both biosynthesized metal NPs were spherical and monodispersed, with average particle sizes of 8.4 nm (Au-CBD) and 4.8 nm (Ag-CBD). This study also explored the potential cytotoxicity of CBD-capped NPs in human keratinocyte cells, which was observed to be of minimal concern. The novel synthesis approach presented in this study is free from harsh chemical reagents; therefore, these NPs can be used in a wide array of applications, including the pharmaceutical and biomedical fields.

Novel UV filters from Pentacalia pulchella extracts with photoprotective properties and antioxidant activity

Most of the plant species found in the high mountain ecosystems of the tropics is unique and exceptional, because they have developed complex adaptations to survive in extreme environmental conditions, such as high levels of UVR and low temperatures of these ecological environments. In an exploratory study carried out on some plants of this ecosystem, we found that one of the most promising species was the Pentacalia pulchella (Kunth) Cuatrec. (Asteraceae) an endemic plant of Colombia, which grows between 2500 and 3500 m.a.s.l. Therefore, the objective of this work was to evaluate the photoprotective, antioxidant, and chemical composition of extracts from the leaves of P. pulchella. Extracts showed good absorption coefficients in UVA-UVB, high content of total phenols, with antioxidant activity comparable to that obtained with butylhydroxytoluene (BHT). Finally, the formulation labeled "7" with 10% extract presented adequate sensory characteristics for topical use, good in vitro photoprotection values in the UVA-UVB range (SPF (Sun Protection Factor): 7.3 ± 0.9, UVAPF (Ultraviolet A Protection Factor): 5.3 ± 0.6, λ_c 376), and antioxidant activity. Results obtained allow us to suggest that the extract of P. pulchella has a high potential as a source of new natural solar filters.

Recent advances in microneedles-based drug delivery device in the diagnosis and treatment of cancer

Microneedles are unique, novel and an effective approach designed to deliver therapeutic agents and immunobiologicals in several diseases. These tiny needle patches are designed to load vaccine, small or large drug molecule, heavy molecular weighted proteins, genes, antibodies, nanoparticles and many more. These nanoparticles loaded microneedles deliver drugs deep within the skin near underlying neutrophils, langerhans and dendritic cells and induces required immunological response. With the drawbacks associated with conventional methods of cancer chemotherapy, the focus was shifted towards use of microneedles in not just anti-cancer vaccine/drug delivery but also for their early diagnosis. This delivery device is also suited for synergistic approaches such as chemotherapy or gene therapy combined with photothermal or photodynamic therapy. The painless self-administrative device offers an alternative over traditional routes of drug delivery including systemic administration via hypodermic needles. Additionally, these microneedles can be fabricated and altered in shape, size and geometry and the material polymer can be chosen depending on use and release mechanism. This review consolidates positive results obtained from studies done for different type of microneedle array in several tumor cell lines and animal models. It further highlights the use of biodegradable polymers such as hydrogel or any dissolving polymer that can be utilized for sustained codelivery of drug/vaccine to shun the need of multiple dosing. It covers the existing limitations that still needs to be resolved and further highlights on the future aspects of their use in cancer therapy.

The circadian clock and diseases of the skin

Organisms have an evolutionarily conserved internal rhythm that helps them anticipate and adapt to daily changes in the environment. Synchronized to the light-dark cycle with a period of around 24 hours, the timing of the circadian clock is set by light-triggering signals sent from the retina to the suprachiasmatic nucleus. Other inputs, including food intake, exercise, and temperature, also affect clocks in peripheral tissues, including skin. Here, we review the intricate interplay between the core clock network and fundamental physiological processes in skin such as homeostasis, regeneration, and immune- and stress responses. We illustrate the effect of feeding time on the skin circadian clock and skin functions, a previously overlooked area of research. We then discuss works that relate the circadian clock and its disruption to skin diseases, including skin cancer, sunburn, hair loss, aging, infections, inflammatory skin diseases, and wound healing. Finally, we highlight the promise of circadian medicine for skin disease prevention and management.

Advanced nanomedicine approaches applied for treatment of skin carcinoma

Skin-cancer is the commonest malignancy affecting huge proportion of the population, reaching heights in terms of morbidity. The treatment strategies are presently focusing on surgery, radiation and chemotherapy, which eventually cause destruction to unaffected cells. To overcome this limitation, wide range of nanoscaled materials have been recognized as potential carriers for delivering selective response to cancerous cells and neoplasms. Nanotechnological approach has been tremendously exploited in several areas, owing to their functional nanometric dimensions. The alarming incidence of skin cancer engenders burdensome effects worldwide, which is further awakening innovational medicinal approaches, accompanying target specific drug delivery tools for coveted benefits to provide reduced toxicity and tackle proliferative episodes of skin cancer. The developed nanosystems for anti-cancer agents include liposomes, ethosomes, nanofibers, solid lipid nanoparticles and metallic nanoparticles, which exhibit pronounced outcomes for skin carcinoma. In this review, skin cancer with its sub-types is explained in nutshell, followed by compendium of specific nanotechnological tools presented, in addition to therapeutic applications of drug-loaded nano systems for skin cancer.

Recent Advances in Phenolic Metabolites and Skin Cancer

Skin cancer represents any tumor development from the cutaneous structures within the epidermis, dermis or subcutaneous tissue, and is considered to be the most prevalent type of cancer. Compared to other types of cancer, skin cancer is proven to have a positive growth rate of prevalence and mortality. There are available various treatments, including chemotherapy, immunotherapy, radiotherapy and targeted therapy, but because of the multidrug resistance development, a low success has been registered. By this, the importance of studying naturally occurring compounds that are both safe and effective in the chemoprevention of skin cancer is emphasized. This review focuses on melanoma because it is the deadliest form of skin cancer, with a significantly increasing incidence in the last decades. As chemopreventive agents, we present polyphenols and their antioxidant activity, anti-inflammatory effect, their ability to balance the cell cycle and to induce apoptosis and their various other effects on skin melanoma. Besides chemoprevention, studies suggest that polyphenols can have treating abilities in some conditions. The limitations of using polyphenols are also pointed out, which are related to their poor bioavailability and stability, but as the technology is well developed, it is possible to augment the efficacy of polyphenols in the case of melanoma.

Calcium Channels: Noteworthy Regulators and Therapeutic Targets in Dermatological Diseases

Dysfunctional skin barrier and impaired skin homeostasis may lead to or aggravate a series of dermatologic diseases. A large variety of biological events and bioactive molecules are involved in the process of skin wound healing and functional recovery. Calcium ions (Ca²⁺) released from intracellular stores as well as influx through plasma membrane are essential to skin function. Growing evidence suggests that calcium influx is mainly regulated by calcium-sensing receptors and channels, including voltage-gated, transient potential receptor, store-operated, and receptor-operated calcium channels, which not only maintain cellular Ca²⁺ homeostasis, but also participate in cell proliferation and skin cell homeostasis through Ca²⁺-sensitive proteins such as calmodulin (CaM). Furthermore, distinct types of Ca²⁺ channels not merely work separately, they may work concertedly to regulate cell function. In this review, we discussed different calcium-sensing receptors and channels, including voltage-gated, transient receptor potential, store-operated, and receptor-operated calcium channels, particularly focusing on their regulatory functions and inherent interactions as well as calcium channels-related reagents and drugs, which is expected to bridge basic research and clinical applications in dermatologic diseases.

Immunopharmacological Properties of Methacrylic Acid Polymers as Potential Polymeric Carrier Constituents of Anticancer Drugs

Cytostatic chemotherapeutics provide a classical means to treat cancer, but conventional treatments have not increased in efficacy in the past years, warranting a search for new approaches to therapy. The aim of the study was, therefore, to obtain methacrylic acid (MAA) (co)polymers and to study their immunopharmacological properties. 4-Cyano-4-[(dodecylsulfanylthiocarbonyl)sulfanyl] pentanoic acid (CDSPA) and 2-cyano-2-propyl dodecyl trithiocarbonate (CPDT) were used as reversible chain transfer agents. Experiments were carried out in Wistar rats. The MTT assay was used to evaluate the cytotoxic effect of the polymeric systems on peritoneal macrophages. An experimental tumor model was obtained by grafting RMK-1 breast cancer cells. Serum cytokine levels of tumor-bearing rats were analyzed. The chain transfer agents employed in classical radical polymerization substantially reduced the molecular weight of the resulting polymers, but a narrow molecular weight distribution was achieved only with CDSPA and high CPDT concentrations. Toxicity was not observed when incubating peritoneal macrophages with polymeric systems. In tumor-bearing rats, the IL-10 concentration was 1.7 times higher and the IL-17 concentration was less than half that of intact rats. Polymeric systems decreased the IL-10 concentration and normalized the IL-17 concentration in tumor-bearing rats. The maximum effect was observed for a MAA homopolymer with a high molecular weight. The anion-active polymers proposed as carrier constituents are promising for further studies and designs of carrier constituents of drug derivatives.

Selected Extracts from High Mountain Plants as Potential Sunscreens with Antioxidant Capacity

The photoprotective and antioxidant activities of extracts of six species of plants collected in a high mountain ecosystem at 3150 m.a.s.l. were evaluated. In vitro photoprotection according to UVA-UVB absorption spectrum, Sun Protection Factor (SPF), UVA Protection Factor (UVAPF), (critical wavelength) λ_c and UVA/UVB Ratio were assessed. Also, the antioxidant activity was determined using the DPPH radical assay and the inhibition of lipid peroxidation in methyl linoleate (MeLo). Total anthocyanins content (TAC) and total polyphenolic content (TPC) were evaluated. Among the extracts evaluated, the extract of B. antioquensis, an endemic plant of Colombia, showed a significant photoprotection against UVA-UVB range, with SPF values of 15 ± 2 and UVAPF of 7 ± 1, λ_c : 378, UVA/UVB Ratio: 0.78. Furthermore, this extract presented an excellent antioxidant activity, with EC₅₀ of 0.17 ± 0.04 g of dry extract/mmol DPPH, a value of TPC of 464 ± 9 mg gallic acid equivalents (GAE)/g dry extract and significant inhibition of MeLo peroxidation. The results suggest that the extract of B. antioquensis has the best quality to be a source of new UV filters, with a broad spectrum of protection and antioxidant properties.

Selective Apoptotic Effect of Plasma Activated Liquids on Human Cancer Cell Lines

Plasma medicine is a new field focusing on biomedical and clinical applications of cold gas plasmas, including their anticancer effects. Cold plasmas can be applied directly or indirectly as plasma-activated liquids (PAL). The effects of plasma-activated cell growth medium (PAM) and plasma-activated phosphate buffered saline (PAPBS) were tested, using a plasma pen generating streamer corona discharge in ambient air, on different cancer cell lines (melanoma A375, glioblastoma LN229 and pancreatic cancer MiaPaCa-2) and normal cells (human dermal fibroblasts HDFa). The viability reduction and apoptosis induction were detected in all cancer cells after incubation in PAL. In melanoma cells we focused on detailed insights to the apoptotic pathways. The anticancer effects depend on the plasma treatment time or PAL concentration. The first 30 min of incubation in PAL were enough to start processes leading to cell death. In fibroblasts, no apoptosis induction was observed, and only PAPBS, activated for a longer time, slightly decreased their viability. Effects of PAM and PAPBS on cancer cells showed selectivity compared to normal fibroblasts, depending on correctly chosen activation time and PAL concentration, which is very promising for potential clinical applications. This selectivity effect of PAL is conceivably induced by plasma-generated hydrogen peroxide.

Nanocarriers for Photodynamic Therapy Intended to Cutaneous Tumors

Photodynamic Therapy (PDT) is a therapeutic modality used for several malignant and premalignant skin disorders, including Bowen's disease skin cancers and Superficial Basal Cell Carcinoma (BCC). Several photosensitizers (PSs) have been explored for tumor destruction of skin cancers, after their activation by a light source of appropriate wavelength. Topical release of PSs avoids prolonged photosensitization reactions associated with systemic administration; however, its clinical usefulness is influenced by its poor tissue penetration and the stability of the active agent. Nanotechnology-based drug delivery systems are promising tool to enhance the efficiency for PDT of cancer. This review focuses on PSs encapsulated in nanocarriers explored for PDT of skin tumors.

Global, regional and national incidence, mortality and disability-adjusted life-years of skin cancers and trend analysis from 1990 to 2019: An analysis of the Global Burden of Disease Study 2019

BACKGROUND

Information about global and local epidemiology and trends of skin cancers is limited, which increases the difficulty of cutaneous cancer control.

METHODS

To estimate the global spatial patterns and temporal trends of skin cancer burden. Based on the GBD 2019, we collected and analyzed numbers and age-standardized rates (ASR) of skin cancer incidence, disability-adjusted life years (DALYs) and mortality (ASIR, ASDR, and ASMR) in 204 countries from 1990 through 2019 were estimated by age, sex, subtype (malignant skin melanoma [MSM], squamous-cell carcinoma [SCC], and basal-cell carcinoma [BCC]), Socio-demographic Index (SDI), region, and country. Temporal trends in ASR were also analyzed using estimated annual percentage change.

RESULTS

Globally, in 2019, there were 4.0 million BCC, 2.4 million SCC, and 0.3 million MSM. There were approximately 62.8 thousand deaths and 1.7 million DALYs due to MSM, and 56.1 thousand deaths and 1.2 million DALYs were attributed to SCC, respectively. The men had higher ASR of skin cancer burden than women. The age-specific rates of global skin cancer burden were higher in the older adults, increasing trends observed from 55 years old. Geographically, the numbers and ASR of skin cancers varied greatly across countries, with the largest burden of ASIR in high SDI regions. However, an unexpected increase was observed in some regions from 1990 to 2019, such as East Asia, and Sub-Saharan Africa. Although there was a slight decrease of the ASMR and ASDR, the global ASIR of MSM dramatically increased, 1990-2019. Also, there was a remarkable increase in ASR of BCC and SCC burden.

CONCLUSIONS

Skin cancer remains a major global public health threat. Reducing morbidity and mortality strategies such as primary and secondary prevention should be reconsidered, especially in the most prevalent and unexpected increased regions, especially for those areas with the greatest proportions of their population over age 55.

Hyalase-Mediated Cascade Degradation of a Matrix Barrier and Immune Cell Penetration by a Photothermal Microneedle for Efficient Anticancer Therapy

For melanoma with high lethality and metastasis rate, traditional therapy has limited effects; local photothermal therapy (PTT) synergetic with immune therapy for cancer treatment can perhaps improve the situation. However, because of the natural existence of the tumor matrix barrier, the penetration depth of drugs and immune cells often dampens the efficacy of cancer treatment. Herein, we report an innovative synergetic PTT and immune therapy through dissolving microneedles for the codelivery of the hyaluronidase-modified semiconductor polymer nanoparticles containing poly(cyclopentadithiophene-alt-benzothiadiazole) and immune adjuvant polyinosinic-polycytidylic acid (PIC). Benefiting from the dissolution of an extracellular matrix of hyaluronidase, the semiconductor polymer nanoparticles and PIC penetrate the tumor deeply, under synergetic therapy with PTT, activating the immune cells and enhancing the T-cell immune response for inhibition of tumor growth and metastasis. This study provides a promising platform for effective melanoma treatment and a novel strategy to overcome the stromal barrier.

DHODH and cancer: promising prospects to be explored

Human dihydroorotate dehydrogenase (DHODH) is a flavin-dependent mitochondrial enzyme catalyzing the fourth step in the de novo pyrimidine synthesis pathway. It is originally a target for the treatment of the non-neoplastic diseases involving in rheumatoid arthritis and multiple sclerosis, and is re-emerging as a validated therapeutic target for cancer therapy. In this review, we mainly unravel the biological function of DHODH in tumor progression, including its crucial role in de novo pyrimidine synthesis and mitochondrial respiratory chain in cancer cells. Moreover, various DHODH inhibitors developing in the past decades are also been displayed, and the specific mechanism between DHODH and its additional effects are illustrated. Collectively, we detailly discuss the association between DHODH and tumors in recent years here, and believe it will provide significant evidences and potential strategies for utilizing DHODH as a potential target in preclinical and clinical cancer therapies.

Chemopreventive effect of dieckol against 7,12-dimethylbenz(a)anthracene induced skin carcinogenesis model by modulatory influence on biochemical and antioxidant biomarkers

Skin cancer is the commonly found type, which contributes to 40% of whole cancer incidences worldwide. Dieckol is an active compound occurs in the marine algae with many biological benefits. In this exploration, we intended to investigate the therapeutic potency of dieckol against the 7,12-dimethylbenz(a)anthracene (DMBA)-triggered skin carcinogenesis in mice. The skin cancer was stimulated to the animals via injecting the 25 μg of DMBA in 100 μL of acetone in shaved dorsal portion along with the 30 mg/kg of dieckol supplementation for 25 week. The antioxidant enzymes and phase-I and -II detoxifying enzymes in the test animals were inspected via standard protocols. Pro-inflammatory markers (IL-6, IL-1β, and TNF-α) level was examined via ELISA kits and the expression of inflammatory molecular markers like p-NF-ƙB, IƙBα and p-IƙBα were studied through western blotting. The expression status of pro- and anti-apoptotic proteins (p53, Bax, Bcl-2, caspase-3, caspase-9, COX-2, TGF-β1) was investigated via real-time polymerase chain reaction (RT-PCR). Our results revealed that the 30 mg/kg of dieckol supplementation noticeably regained the body and liver weight and also diminished the tumor incidence in the DMBA-incited animals. Dieckol treatment exhibited an enhanced antioxidants (SOD, CAT, GPx, and GSH) and reduced phase-I enzymes Cyt-p450 and Cyt-b5 in the DMBA-induced animals. Dieckol also diminished the pro-inflammatory modulators like IL-6, IL-1β and TNF-α. Western blotting result evidenced that the dieckol was inhibited the IƙB/NF-ƙB signaling pathway. RT-PCR study proved the enhanced expression of pro-apoptotic protein (p53, Bax, caspase-3 and -9) in the dieckol treated animals. Histological study also confirmed the therapeutic benefits of Dieckol. Altogether with these findings, it was clear that the dieckol has appreciably allayed the DMBA activated skin tumorigenesis in the mice and it could be a promising agent to treat the human skin cancer in future.

Pathogenesis of Keratinocyte Carcinomas and the Therapeutic Potential of Medicinal Plants and Phytochemicals

Keratinocyte carcinoma (KC) is a form of skin cancer that develops in keratinocytes, which are the predominant cells present in the epidermis layer of the skin. Keratinocyte carcinoma comprises two sub-types, namely basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). This review provides a holistic literature assessment of the origin, diagnosis methods, contributing factors, and current topical treatments of KC. Additionally, it explores the increase in KC cases that occurred globally over the past ten years. One of the principal concepts highlighted in this article is the adverse effects linked to conventional treatment methods of KC and how novel treatment strategies that combine phytochemistry and transdermal drug delivery systems offer an alternative approach for treatment. However, more in vitro and in vivo studies are required to fully assess the efficacy, mechanism of action, and safety profile of these phytochemical based transdermal chemotherapeutics.

Combined Toxicity of Gas Plasma Treatment and Nanoparticles Exposure in Melanoma Cells In Vitro

Despite continuous advances in therapy, cancer remains a deadly disease. Over the past years, gas plasma technology emerged as a novel tool to target tumors, especially skin. Another promising anticancer approach are nanoparticles. Since combination therapies are becoming increasingly relevant in oncology, both gas plasma treatment and nanoparticle exposure were combined. A series of nanoparticles were investigated in parallel, namely, silica, silver, iron oxide, cerium oxide, titanium oxide, and iron-doped titanium oxide. For gas plasma treatment, the atmospheric pressure argon plasma jet kINPen was utilized. Using three melanoma cell lines, the two murine non-metastatic B16F0 and metastatic B16F10 cells and the human metastatic B-Raf mutant cell line SK-MEL-28, the combined cytotoxicity of both approaches was identified. The combined cytotoxicity of gas plasma treatment and nanoparticle exposure was consistent across all three cell lines for silica, silver, iron oxide, and cerium oxide. In contrast, for titanium oxide and iron-doped titanium oxide, significantly combined cytotoxicity was only observed in B16F10 cells.

Plant derived coumestrol phytochemical targets human skin carcinoma cells by inducing mitochondrial-mediated apoptosis, cell cycle arrest, inhibition of cell migration and invasion and modulation of m-TOR/PI3K/AKT signalling pathway

The current study was undertaken to investigate anticancer activity of coumestrol phytoestrogen against human skin cancer. MTT assay was performed for cell viability assessment and clonogenic assay for cell colony formation assessment. Apoptosis was analysed by Annexin V/FITC staining, AO/EB staining and western blotting assays. Effects on the m-TOR/PI3K/AKT signalling pathway were investigated by western blotting. Results indicated that coumestrol induced significant toxicity in human skin cancer cells in contrast to mouse skin cancer cells. The proliferation rate in normal skin cells remained almost intact. Annexin V-FITC and AO/EB staining assays indicated coumestrol induced cytotoxicity in skin cancer cells is mediated through apoptosis stimulation. The apoptosis in skin cancer cells was mediated through caspase-activation. Cell migration and invasion was inhibited by coumestrol in human skin cancer cells via inhibition of MMP-2 and MMP-9 expressions. Moreover, m-TOR/PI3K/AKT signalling pathway in SKEM-5 cells was blocked by coumestrol.

A hierarchical three-step superpixels and deep learning framework for skin lesion classification

Skin cancer is one of the most common and dangerous cancer that exists worldwide. Malignant melanoma is one of the most dangerous skin cancer types has a high mortality rate. An estimated 196,060 melanoma cases will be diagnosed in 2020 in the USA. Many computerized techniques are presented in the past to diagnose skin lesions, but they are still failing to achieve significant accuracy. To improve the existing accuracy, we proposed a hierarchical framework based on two-dimensional superpixels and deep learning. First, we enhance the contrast of original dermoscopy images by fusing local and global enhanced images. The entire enhanced images are utilized in the next step to segmentation skin lesions using three-step superpixel lesion segmentation. The segmented lesions are mapped over the whole enhanced dermoscopy images and obtained only segmented color images. Then, a deep learning model (ResNet-50) is applied to these mapped images and learned features through transfer learning. The extracted features are further optimized using an improved grasshopper optimization algorithm, which is later classified through the Naïve Bayes classifier. The proposed hierarchical method has been evaluated on three datasets (Ph2, ISBI2016, and HAM1000), consisting of three, two, and seven skin cancer classes. On these datasets, our method achieved an accuracy of 95.40%, 91.1%, and 85.50%, respectively. The results show that this method can be helpful for the classification of skin cancer with improved accuracy.

Generation of Nano-pores in Silk Fibroin Films Using Silk Nanoparticles for Full-Thickness Wound Healing

Silk fibroin films are used in tissue engineering due to their biocompatibility, optical clarity, and slow biodegradability. However, the relatively smooth surface and low permeability of these systems may limit some applications; thus, here, a method was developed to generate nano-pores in methanol or ethanol-treated silk fibroin films. The first step was to induce the formation of nanoparticles (50-300 nm diam.) in silk fibroin solutions by autoclaving. After drying in air, the films formed were treated to induce silk β-sheet structures, which condense the bulk silk phase and nanoparticles and phase separation and enlarge the space of bulk silk phase and nanoparticles. These films were then extracted with water to allow the condensed nanoparticles to escape, leaving homogeneous nano-pores (50-300 nm) in the silk fibroin matrix. The introduction of nano-pores resulted in enhanced permeability and minimized loss of the mechanical properties of the nano-porous silk fibroin films (NSFs) when compared to the un-autoclaving-treated silk fibroin films. NSFs promoted cell (human fibroblasts) proliferation and oxygen/nutrition perfusion and significantly enhanced the complete skin-thickness wound healing in a rat model, suggesting the potential use in tissue regeneration or as wound dressing biomaterials for clinical applications.

Receptor-mediated photothermal/photodynamic synergistic anticancer nanodrugs with SERS tracing function

Phototherapy, especially the photothermal therapy (PTT) and the photodynamic therapy (PDT), have become very promising in cancer treatment due to its low invasiveness and high efficacy. Both PTT and PDT involve the utilization of light energy, and their synergistic treatment should be a good solution for cancer treatment by ingenious design. The therapeutic effect of phototherapy is closely associated with the amount and location of anticancer-nanodrugs accumulated in tumor cells, and the receptor-mediated endocytosis should be an excellent candidate for enhancing anticancer-nanodrugs internalization. Surface enhanced Raman spectroscopy (SERS) imaging is suitable for tracing nanodrugs due to its high selectivity, sensitivity and reliability. In this paper, we hope to construct a receptor-mediated PTT/PDT synergistic anticancer nanodrugs and evaluate the corresponding efficacy through SERS tracing function. Here, the receptor-mediated PTT/PDT synergistic anticancer nanodrugs are prepared by the chemical modification of gold nanorods (GNRs), involving protoporphyrin IX (PpIX), 4-mecaptobenzoic acid (MBA), and folic acid (FA). The achieved results show that the receptor-mediated endocytosis can greatly facilitate the internalized amount and intracellular distribution of the nanodrugs, thus lead to the anti-cancer efficacy improvement. Importantly, this receptor-mediated PTT/PDT synergistic treatment with SERS tracing function will provide a simple and effective strategy for the design and application of anticancer phototherapy nanodrugs.

Biodegradable conductive multifunctional branched poly(glycerol-amino acid)-based scaffolds for tumor/infection-impaired skin multimodal therapy

The tumor/infection-impaired skin regeneration is still a challenge and the single modal therapy strategy is usually inefficient. Herein, a multimodal tumor therapy and antiinfection method based on the conductive multifunctional poly(glycerol-amino acid)-based scaffolds is reported. The multifunctional conductive scaffolds were formed through the crosslinking between branched poly(glycerol-amino acid), polypyrrole@polydopamine (PPy@PDA) nanoparticles and aldehyde F127 (PGFP scaffolds). PGFP scaffolds possessed controlled electrical conductivity, skin-adhesive behavior, broad-spectrum antibacterial activity, photothermal-responsive drug release and good cytocompatibility. Thus, PGFP scaffolds demonstrated the significant photothermo-chemo tumor and multidrug resistant infection therapy in vitro and in vivo, while promoting granulation tissue formation, collagen deposition, vascular endothelial differentiation and accelerated skin regeneration. This work also firstly demonstrated the important role of multifunctional conductive PPy@PDA nanoparticles in tumor/infection-impaired skin multimodal therapy. This study suggests that efficient multimodal therapy on diseased-impaired skin could be achieved through optimizing the structure and multifunctional properties of biomaterials.

Microneedles Drug Delivery Systems for Treatment of Cancer: A Recent Update

Microneedles (MNs) are tiny needle like structures used in drug delivery through layers of the skin. They are non-invasive and are associated with significantly less or no pain at the site of administration to the skin. MNs are excellent in delivering both small and large molecules to the subjects in need thereof. There exist several strategies for drug delivery using MNs, wherein each strategy has its pros and cons. Research in this domain lead to product development and commercialization for clinical use. Additionally, several MN-based products are undergoing clinical trials to evaluate its safety, efficacy, and tolerability. The present review begins by providing bird's-eye view about the general characteristics of MNs followed by providing recent updates in the treatment of cancer using MNs. Particularly, we provide an overview of various aspects namely: anti-cancerous MNs that work based on sensor technology, MNs for treatment of breast cancer, skin carcinoma, prostate cancer, and MNs fabricated by additive manufacturing or 3 dimensional printing for treatment of cancer. Further, the review also provides limitations, safety concerns, and latest updates about the clinical trials on MNs for the treatment of cancer. Furthermore, we also provide a regulatory overview from the "United States Food and Drug Administration" about MNs.

In vitro Studies of Antitumor Effect, Toxicity/Cytotoxicity and Skin Permeation/Retention of a Green Fluorescence Pyrene-based Dye for PDT Application

Photosensitizers (PS) are compounds that can generate reactive oxygen species under irradiation of appropriate light and are widely used in photodynamic therapy (PDT). Currently, topical PDT is an effective treatment for several skin diseases, including bacterial infections, fungal mycoses and psoriasis. In addition, PDT is also used to treat nonmelanoma skin cancer and can be a potential tool for melanoma, associated with other treatments. In this work, we evaluated the antitumor photoactivity of a new pyrene-based PS (TPPy) by using the murine melanoma cell line (B16F10). The in vitro permeation/retention tests in porcine ear skin were also performed in order to evaluate the potential application of the PS for topical use in skin cancer. Moreover, to determine the toxicity in vivo, we used the Galleria mellonella as an alternative animal model of study. The results showed that TPPy is a promising PS for application in PDT, with potential antitumor photoactivity (IC₅₀ 6.5 μmol L^-1 ), absence of toxicity in the G. mellonella model at higher concentration (70.0 mmol L^-1 ) and the accumulation tendency in the epidermis plus dermis sites (165.20 ± 4.12 ng cm^-2 ).

Stimuli-responsive and cellular targeted nanoplatforms for multimodal therapy of skin cancer

Interdisciplinary applications of nanopharmaceutical sciences have tremendous potential for enhancing pharmacokinetics, efficacy and safety of cancer therapy. The limitations of conventional therapeutic platforms used for skin cancer therapy have been largely overcome by the use of nanoplatforms. This review discusses various nanotechnological approaches experimented for the treatment of skin cancer. The review describes various polymeric, lipidic and inorganic nanoplatforms for efficient therapy of skin cancer. The stimuli-responsive nanoplatforms such as pH-responsive as well as temperature-responsive platforms have also been reviewed. Different strategies for potentiating the nanoparticles application for cancer therapy such as surface engineering, conjugation with drugs, stimulus-responsive and multimodal effect have also been discussed and compared with the available conventional treatments. Although, nanopharmaceuticals face challenges such as toxicity, cost and scale-up, efforts put-in to improve these drawbacks with continuous research would deliver exciting and promising results in coming days.

Anti-Melanoma Activities of Artemisone and Prenylated Amino-Artemisinins in Combination With Known Anticancer Drugs

The most frequently occurring cancers are those of the skin, with melanoma being the leading cause of death due to skin cancer. Breakthroughs in chemotherapy have been achieved in certain cases, though only marginal advances have been made in treatment of metastatic melanoma. Strategies aimed at inducing redox dysregulation by use of reactive oxygen species (ROS) inducers present a promising approach to cancer chemotherapy. Here we use a rational combination of an oxidant drug combined with a redox or pro-oxidant drug to optimize the cytotoxic effect. Thus we demonstrate for the first time enhanced activity of the amino-artemisinin artemisone and novel prenylated piperazine derivatives derived from dihydroartemisinin as the oxidant component, and elesclomol-Cu(II) as the redox component, against human malignant melanoma cells A375 in vitro. The combinations caused a dose dependent decrease in cell numbers and increase in apoptosis. The results indicate that oxidant-redox drug combinations have considerable potential and warrant further investigation.

Developing [60]Fullerene Nanomaterials for Better Photodynamic Treatment of Non-Melanoma Skin Cancers

Skin cancer is the most common cancer in the U.S.A. and Europe. Its subtype, squamous skin carcinoma (SCC), if allowed to grow, has the potential to metastasize and can become deadly. Currently, carbon nanomaterials are being developed to treat cancer due to their attractive physicochemical and biological properties such as an enhanced permeability effect and their ability to produce reactive oxygen species. Here, we describe the synthesis of two water-soluble aminofullerenes (MonoaminoC₆₀ and HexakisaminoC₆₀), which were evaluated as novel [60]fullerene based photosentizers exhibiting anticancer properties. Moreover, the previously described neutral glycofullerene GF1 and its peracetylated lipophilic precursor MMS48 were compared with the aminofullerenes for their ability to generate reactive oxygen species and oxidize lipids. Remarkably, the generation of singlet oxygen and a superoxide radical by HexakisaminoC₆₀ was found to be markedly elevated in the presence of bovine serum albumin and NADH, respectively. Mechanistic studies of lipid peroxidation using cholesterol as a unique reporter molecule revealed that although all four fullerene nanomaterials primarily generated singlet oxygen, superoxide anion was also formed, which suggest a mixed mechanism of action (in which Type I and Type II photochemistry is involved). The [60]fullerene derivative HexakisaminoC₆₀ was also studied for its phototoxicity in squamous skin cancer cell line (A431) using the MTT test and propidium iodide staining.

Hydrogel-Based Technologies for the Diagnosis of Skin Pathology

Hydrogels, swellable hydrophilic polymer networks fabricated through chemical cross-linking or physical entanglement are increasingly utilized in various biomedical applications over the past few decades. Hydrogel-based microparticles, dressings and microneedle patches have been explored to achieve safe, sustained and on-demand therapeutic purposes toward numerous skin pathologies, through incorporation of stimuli-responsive moieties and therapeutic agents. More recently, these platforms are expanded to fulfill the diagnostic and monitoring role. Herein, the development of hydrogel technology to achieve diagnosis and monitoring of pathological skin conditions are highlighted, with proteins, nucleic acids, metabolites, and reactive species employed as target biomarkers, among others. The scope of this review includes the characteristics of hydrogel materials, its fabrication procedures, examples of diagnostic studies, as well as discussion pertaining clinical translation of hydrogel systems.

Advancement in Nanotheranostics for Effective Skin Cancer Therapy: State of the Art

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The skin cancer has become a leading concern worldwide as a result of high mortality rate. The treatment modality involves radiation therapy, chemotherapy or surgery. More often combination therapy of chemotherapeutic agents gives better solution over single chemotherapeutic agent. The Globocon report suggested that high incidence and mortality rate in skin cancer is growing day-to-day. This type of cancer is more prevalent in that area where a person is highly exposed to sunlight. The nanotechnology-based therapy is nowadays drawing attention and becoming a more important issue to be discussed. The nanotherapy of skin cancer is dealt with various approaches and strategies. The strategic based approaches imply nanoparticles targeting carcinoma cells, functionalized nanoparticles for specific targeting to cancer cells, receptor-mediated active targeting as nanoshells, nanostrutured lipid carriers, liposome, ethosome, bilosome, polymeric nanoparticle, nanosphere, dendrimers, carbon nanotubes, quantum dots, solid lipid nanoparticles and fullerenes which are highly efficient in specific killing of cancer cells. The passive targeting of chemotherapeutic agents is also helpful in dealing with carcinoma due to enhanced permeability and retention effect (EPR).

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The article outlines nano-based therapy currently focused globally, and the outcomes of the therapy as well.

Cancer Stem Cells: Acquisition, Characteristics, Therapeutic Implications, Targeting Strategies and Future Prospects

Since last two decades, the major cancer research has focused on understanding the characteristic properties and mechanism of formation of Cancer stem cells (CSCs), due to their ability to initiate tumor growth, self-renewal property and multi-drug resistance. The discovery of the mechanism of acquisition of stem-like properties by carcinoma cells via epithelial-mesenchymal transition (EMT) has paved a way towards a deeper understanding of CSCs and presented a possible avenue for the development of therapeutic strategies. In spite of years of research, various challenges, such as identification of CSC subpopulation, lack of appropriate experimental models, targeting cancer cells and CSCs specifically without harming normal cells, are being faced while dealing with CSCs. Here, we discuss the biology and characteristics of CSCs, mode of acquisition of stemness (via EMT) and development of multi-drug resistance, the role of tumor niche, the process of dissemination and metastasis, therapeutic implications of CSCs and necessity of targeting them. We emphasise various strategies being developed to specifically target CSCs, including those targeting biomarkers, key pathways and microenvironment. Finally, we focus on the challenges that need to be subdued and propose the aspects that need to be addressed in future studies in order to broaden the understanding of CSCs and develop novel strategies to eradicate them in clinical applications. Graphical Abstract Cancer Stem Cells(CSCs) have gained much attention in the last few decades due to their ability to initiate tumor growth and, self-renewal property and multi-drug resistance. Here, we represent the CSC model of cancer, Characteristics of CSCs, acquisition of stemness and metastatic dissemination of cancer, Therapeutic implications of CSCs and Various strategies being employed to target and eradicate CSCs.