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      Ultrasensitive tumour-penetrating nanosensors of protease activity

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          Abstract

          The ability to identify cancer lesions with endogenous biomarkers is currently limited to tumours ~1 cm in diameter. We recently reported an exogenously administered tumour-penetrating nanosensor that sheds, in response to tumour-specific proteases, peptide fragments that can then be detected in the urine. Here, we report the optimization, informed by a pharmacokinetic mathematical model, of the surface presentation of the peptide substrates to both enhance on-target protease cleavage and minimize off-target cleavage, and of the functionalization of the nanosensors with tumour-penetrating ligands that engage active trafficking pathways to increase activation in the tumour microenvironment. The resulting nanosensor discriminated sub-5 mm lesions in human epithelial tumours and detected nodules with median diameters smaller than 2 mm in an orthotopic model of ovarian cancer. We also demonstrate enhanced receptor-dependent specificity of signal generation in the urine in an immunocompetent model of colorectal liver metastases, and in situ activation of the nanosensors in human tumour microarrays when re-engineered as fluorogenic zymography probes.

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          Most cited references28

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          Analysis of nanoparticle delivery to tumours

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            Long-Term Mortality after Screening for Colorectal Cancer

            In randomized trials, fecal occult-blood testing reduces mortality from colorectal cancer. However, the duration of the benefit is unknown, as are the effects specific to age and sex. In the Minnesota Colon Cancer Control Study, 46,551 participants, 50 to 80 years of age, were randomly assigned to usual care (control) or to annual or biennial screening with fecal occult-blood testing. Screening was performed from 1976 through 1982 and from 1986 through 1992. We used the National Death Index to obtain updated information on the vital status of participants and to determine causes of death through 2008. Through 30 years of follow-up, 33,020 participants (70.9%) died. A total of 732 deaths were attributed to colorectal cancer: 200 of the 11,072 deaths (1.8%) in the annual-screening group, 237 of the 11,004 deaths (2.2%) in the biennial-screening group, and 295 of the 10,944 deaths (2.7%) in the control group. Screening reduced colorectal-cancer mortality (relative risk with annual screening, 0.68; 95% confidence interval [CI], 0.56 to 0.82; relative risk with biennial screening, 0.78; 95% CI, 0.65 to 0.93) through 30 years of follow-up. No reduction was observed in all-cause mortality (relative risk with annual screening, 1.00; 95% CI, 0.99 to 1.01; relative risk with biennial screening, 0.99; 95% CI, 0.98 to 1.01). The reduction in colorectal-cancer mortality was larger for men than for women in the biennial-screening group (P=0.04 for interaction). The effect of screening with fecal occult-blood testing on colorectal-cancer mortality persists after 30 years but does not influence all-cause mortality. The sustained reduction in colorectal-cancer mortality supports the effect of polypectomy. (Funded by the Veterans Affairs Merit Review Award Program and others.).
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              The case for early detection.

              Early detection represents one of the most promising approaches to reducing the growing cancer burden. It already has a key role in the management of cervical and breast cancer, and is likely to become more important in the control of colorectal, prostate and lung cancer. Early-detection research has recently been revitalized by the advent of novel molecular technologies that can identify cellular changes at the level of the genome or proteome, but how can we harness these new technologies to develop effective and practical screening tests?
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                Author and article information

                Journal
                101696896
                45929
                Nat Biomed Eng
                Nat Biomed Eng
                Nature biomedical engineering
                2157-846X
                17 March 2017
                10 April 2017
                2017
                10 October 2017
                : 1
                : 0054
                Affiliations
                [1 ]Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139
                [2 ]Harvard–MIT Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139
                [3 ]Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
                [4 ]Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139
                [5 ]Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115
                [6 ]Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA 02139
                [7 ]Howard Hughes Medical Institute, Cambridge, MA 02139
                Author notes
                [* ]Corresponding Author: Sangeeta N. Bhatia, Address: 500 Main Street, 76-453, Cambridge, MA 02142, USA, Phone: 617-253-0893, Fax: 617-324-0740, sbhatia@ 123456mit.edu
                [†]

                These authors contributed equally

                Article
                NIHMS856834
                10.1038/s41551-017-0054
                5621765
                28970963
                a3f25a47-ca14-4c1d-9baa-6c988aa6c24e

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