METHODS: Application of nanotechnology in medicine have perceived a great evolution during past few decades. Nanoemulsion, submicron sized thermodynamically stable distribution of two immiscible liquids, has gained extensive importance as a nanocarrier to improve chemotherapies seeking to overcome the limitations of drug solubilization, improving systemic delivery of the chemotherapeutics to the site of action to achieve a promising inhibitory in tumor growth profile with reduced systemic toxicity.
RESULTS AND CONCLUSION: This review has focused on potential application of nanoemulsion in the translational research and its role in chemotherapy using oral, parenteral and transdermal route to enhance systemic availability of poorly soluble drug. In summary, nanoemulsion is a multifunctional nanocarrier capable of enhancing drug delivery potential of cytotoxic agents, thereby, can improve the outcomes of cancer treatment by increasing the life-span of the patient and quality of life, however, further clinical research and characterization of interactive reactions should need to be explored.
AIM OF REVIEW: The review encapsulates the transformative trajectory of green CDs as future anticancer nanomedicine, poised to redefine the strategies employed in the ongoing fight against cancer.
KEY SCIENTIFIC CONCEPTS OF REVIEW: The versatility of CDs was rooted in their various synthesis approaches and sustainable strategies, enabling their adaptability for diverse therapeutic uses. In vitro studies had showcased CDs' selective cytotoxicity against cancer cells while sparing healthy counterparts, forming the basis for targeted therapeutic potential. This selectivity had been attributed to the reactive oxygen species (ROS) generation, which opened avenues for targeted interventions. The role of CDs in combination therapies, synergizing with chemotherapy, radiotherapy, and targeted approaches was then investigated to heighten their anticancer efficacy. Notably, in vivo studies highlight CDs' remarkable biocompatibility and minimal side effects, endorsing their translational promise. Integration with conventional cancer treatments such as chemotherapy, radiotherapy, and immunotherapy amplified the versatility and effectiveness of CDs. The exploration of CDs' applications in photo-induced treatments further solidified their significance, positioning them as photosensitizers (PS) in photodynamic therapy (PDT) and photothermal agents (PA) in photothermal therapy (PTT). In PDT, CDs triggered the generation of ROS upon light exposure, facilitating cancer cell elimination, while in PTT, they induced localized hyperthermia within cancer cells, enhancing therapeutic outcomes. In vitro and in vivo investigations validated CDs' efficacy in PDT and PTT, affirming their potential for integration into combination therapies. Looking ahead, the future of CDs in anticancer treatment encompasses bioavailability, biocompatibility, synergistic treatments, tumor targeting, artificial intelligence (AI) and robotics integration, personalized medicine, and clinical translation. This transformative odyssey of CDs as future anticancer agents is poised to redefine the paradigm of cancer treatment strategies.
MATERIALS AND METHODS: A single-blinded Randomized Controlled Clinical Trial was conducted at the IKN between January 2023 and June 2023. The estimated sample size was 120 participants. A sequential numbering system assigned a unique identifier to each participant until a total of 120 participants were recruited, with 60 participants in both the intervention and control groups. The intervention group received chemotherapy counselling using a newly developed module. QoL and depression were assessed at multiple time points using a validated questionnaire. Data were analysed using SPSS version 26, with independent tests and two-way repeated measures ANOVA. A p-value < 0.05 was considered significant, and partial eta squared was used to measure effect size.
RESULT: Overall, in age distribution, the intervention group had the highest percentage of participants in the 41-60 years category (40.0%), whereas the control group had the highest percentage of participants aged ≥61 years (38.3%). The counselling module was effective in improving QoL and depression among participants at baseline and for three consecutive follow-ups following interventions. The QoL showed improvement in all four domains in the intervention group, which were Physical Health (p < 0.001), Psychological (p < 0.001), Social Relationship (p < 0.001), and Environment (p = 0.001). There was also a moderate effect reduction on depression (p < 0.001).
CONCLUSION: The newly developed counselling module was effective in improving the QoL and depression among breast cancer patients. Repetitive counselling sessions by pharmacists, which were conducted during the module implementation, played a key role in ensuring the well-being of breast cancer patients throughout the treatment journey.