Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2021; 13(10): 1213-1228
Published online Oct 15, 2021. doi: 10.4251/wjgo.v13.i10.1213
Engineering nanotheranostic strategies for liver cancer
Lei Cao, Yu-Qin Zhu, Zhi-Xian Wu, Gao-Xiong Wang, Hong-Wei Cheng
Lei Cao, Yu-Qin Zhu, Gao-Xiong Wang, Department of Pathology, Quanzhou Women's and Children's Hospital, Quanzhou 362000, Fujian Province, China
Zhi-Xian Wu, Department of Hepatobiliary Disease, The 900th Hospital of the People’s Liberation Army Joint Service Support Force, Fuzhou 350025, Fujian Province, China
Hong-Wei Cheng, School of Public Health, Xiamen University, Xiamen 361002, Fujian Province, China
Author contributions: Cao L and Zhu YQ conducted the literature manufacture and drafted the manuscript, and contributed equally to this study; Wu ZX provided technological support and contributed to the project discussion; Wang GX and Cheng HW had equal contributions to the conceptualization of this study and authentication of the validity of the reported results.
Supported by Science and Technology Innovation Joint Fund Project of Fujian Province, No. 2019Y9044; and Science and Technology Project of Quanzhou, No. 2018Z155.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hong-Wei Cheng, MD, Research Associate, School of Public Health, Xiamen University, Xiangan South Road, Xiangan District, Xiamen 361002, Fujian Province, China.
Received: March 22, 2021
Peer-review started: March 22, 2021
First decision: June 14, 2021
Revised: June 28, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: October 15, 2021

The incidence and mortality of hepatocellular carcinoma have continued to increase over the last few years, and the medicine-based outlook of patients is poor. Given great ideas from the development of nanotechnology in medicine, especially the advantages in the treatments of liver cancer. Some engineering nanoparticles with active targeting, ligand modification, and passive targeting capacity achieve efficient drug delivery to tumor cells. In addition, the behavior of drug release is also applied to the drug loading nanosystem based on the tumor microenvironment. Considering clinical use of local treatment of liver cancer, in situ drug delivery of nanogels is also fully studied in orthotopic chemotherapy, radiotherapy, and ablation therapy. Furthermore, novel therapies including gene therapy, phototherapy, and immunotherapy are also applied as combined therapy for liver cancer. Engineering nonviral polymers to function as gene delivery vectors with increased efficiency and specificity, and strategies of co-delivery of therapeutic genes and drugs show great therapeutic effect against liver tumors, including drug-resistant tumors. Phototherapy is also applied in surgical procedures, chemotherapy, and immunotherapy. Combination strategies significantly enhance therapeutic effects and decrease side effects. Overall, the application of nanotechnology could bring a revolutionary change to the current treatment of liver cancer.

Keywords: Liver cancer, Poor prognosis, Nanotheranostic, Drug delivery, Gene delivery, Combination therapy

Core Tip: With the development of nanotheranostic strategies for liver cancer treatment, the efficacy of drug delivery is improved by smart nanoparticles with excellent targeting capacity. To overcome the complex tumor microenvironment, nanosystems with combined strategies of curative or palliative treatments have significant synergistic therapeutic effect against unfavorable clinical obstacles in the treatment of liver cancer.