Targeting cancer-inducing inflammation: Current advancements and future prospects

Inflammation is a central aspect of the immune system that serves as a defense mechanism of the body to protect against potential pathogens, prevent further damage of body tissues, and induce repair mechanisms. However, chronic inflammation is often associated with the development and progression of cancer, whereby an unresolved inflammation can continue to perturb the cellular microenvironment, which in turn can alter cancer-related genes and posttranslational modification of major cellular proteins responsible for cell cycle, DNA repair, and cell apoptosis. Besides, tumor progression and metastasis are also greatly influenced by the presence of inflammatory cells and immunomodulatory mediators within the tumor microenvironment. Therefore, the targeting of inflammation represents a great strategy in the prevention and therapy of cancer. Despite the multitude of therapeutic agents currently in use to combat different types of cancer, the full pharmacological success of these agents is limited by several shortcomings, which include poor biodistribution that requires high doses to achieve an optimal therapeutic concentration in the target tissues, leading to off-target toxicities, as well as rapid degradation that reduces therapeutic efficacy. As such, the therapeutic index of these agents can be further enhanced through a nanomedicine-based approach, as drug delivery nanocarriers can exploit the unique biological and physical features of the tumor microenvironment to gain access to tumor tissues with specificity while reducing systemic adverse effects. In this chapter, we discuss the roles of inflammation in the development and progression of cancer, along with the advantages and limitations of conventional therapeutics. We then present the potential of nanomedicine-based drug delivery approaches to selectively direct anticancer agents to the tumor tissues.