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      Tumor targeting via EPR: Strategies to enhance patient responses

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          Abstract

          The tumor accumulation of nanomedicines relies on the enhanced permeability and retention (EPR) effect. In the last 5-10 years, it has been increasingly recognized that there is a large inter- and intra-individual heterogeneity in EPR-mediated tumor targeting, explaining the heterogeneous outcomes of clinical trials in which nanomedicine formulations have been evaluated. To address this heterogeneity, as in other areas of oncology drug development, we have to move away from a one-size-fits-all tumor targeting approach, towards methods that can be employed to individualize and improve nanomedicine treatments. To this end, efforts have to be invested in better understanding the nature, the complexity and the heterogeneity of the EPR effect, and in establishing systems and strategies to enhance, combine, bypass and image EPR-based tumor targeting. In the present manuscript, we summarize key studies in which these strategies are explored, and we discuss how these approaches can be employed to enhance patient responses.

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          Author and article information

          Journal
          Advanced Drug Delivery Reviews
          Advanced Drug Delivery Reviews
          Elsevier BV
          0169409X
          May 2018
          May 2018
          : 130
          : 17-38
          Article
          10.1016/j.addr.2018.07.007
          6130746
          30009886
          © 2018

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