Clinical cancer treatment modalities include radiation as one of the first-line therapies used for treating almost two-thirds of cancer patients. Combinational therapy for cancer is becoming extremely popular, with multiple therapies and their pharmacological effects expected to provide a synergistic outcome. The nanotechnology-based combinational therapeutic approach is emerging as a more effective strategy, for its advantages include simultaneous loading of multiple drugs, on-demand drug delivery controlled by external or internal stimulus, targeting a particular site, and the potential to combine physical treatment modalities (like radiation, thermal therapies, etc.) with chemical interventions (like chemotherapy, immunotherapy, etc.). We report a combination of radiotherapy and chemotherapy mediated by a multifunctional lipo-polymeric hybrid nanosystem coated with gold, demonstrating the three different functionalities using a single nanosystem: a) radio sensitization, b) radiation-triggered delivery of drugs, and c) application as an X-ray/CT contrast agent. The lipo-polymeric hybrid nanoparticles, synthesized using a modified hydrogel isolation method, were loaded with a natural plant-derived anti-cancer agent “Caflanone.” These nanoparticles were further subjected to in-situ reduction for a surface coating of gold, which provided enhanced radiosensitivity, radiation triggered drug delivery and X-ray/CT imaging. This approach using a multifunctional nanosystem leverages the biocompatibility of the lipo-polymeric hybrid system for the loading of drugs, precise spatiotemporal controllability of radiation for drug release, and the cytotoxicity of the plant-derived anti-cancer agent “Caflanone.” A significant therapeutic efficacy in vitro against breast cancer (p = 0.0002), pancreatic cancer (p < 0.0001), and glioblastoma (p < 0.0001) was demonstrated with the combinational approach. The application of the nanosystem as an X-ray/CT contrast agent has been shown in vivo in tumor-bearing mice and the safety profile and histopathology evaluated in healthy mice showed no adverse effects. A significant increase (p = 0.01) in the survival of breast tumor-bearing mice treated with a combinational approach was also demonstrated. The engineered multifunctional nanoparticles enhanced the radiation therapy and triggered the drug release at the tumor site, triggering the action of encapsulated chemotherapeutic agents while providing image guidance.

Globally, cervical cancer is the fourth leading cancer among women and is dominant in resource-poor settings in its occurrence and mortality. This study focuses on developing liquid immunogenic fiducial eluter (LIFE) Biomaterial with components that include biodegradable polymers, nanoparticles, and an immunoadjuvant. LIFE Biomaterial is designed to provide image guidance during radiotherapy similar to clinically used liquid fiducials while enhancing therapeutic efficacy for advanced cervical cancer. C57BL6 mice were used to grow subcutaneous tumors on bilateral flanks. The tumor on one flank was then treated using LIFE Biomaterial prepared with the immunoadjuvant anti-CD40, with/without radiotherapy at 6 Gy. Computed tomography (CT) and magnetic resonance (MR) imaging visibility were also evaluated in human cadavers. A pharmacodynamics study was also conducted to assess the safety of LIFE Biomaterial in healthy C57BL6 female mice. Results showed that LIFE Biomaterial could provide both CT and MR imaging contrast over time. Inhibition in tumor growth and prolonged significant survival (* p < 0.05) were consistently observed for groups treated with the combination of radiotherapy and LIFE Biomaterial, highlighting the potential for this strategy. Minimal toxicity was observed for healthy mice treated with LIFE Biomaterial with/without anti-CD40 in comparison to non-treated cohorts. The results demonstrate promise for the further development and clinical translation of this approach to enhance the survival and quality of life of patients with advanced cervical cancer.

Background and Objective: In 2023, the World Health Organization (WHO) launched the Global Breast Cancer Initiative (GBCI) framework to achieve a 2.5% reduction in annual breast cancer mortality through its three key performance indicators of early screening, timely breast diagnosis, and comprehensive treatment management. National cancer registries serve as a vital tool for implementing the GBCI framework, providing a robust mechanism to track progress, evaluate outcomes, and ensure accountability in its execution. The objective of this study was to evaluate the status of cancer registries in West Africa as a marker for the region’s preparedness to implement the GBCI framework. Methods: This narrative review searched for published literature in PubMed, international health and conference websites, and world population data sources using our search keywords to identify the status of cancer registries in West Africa. Published literature on Ghana’s journey towards registry development was additionally utilized to develop a descriptive case analysis of the barriers and facilitators of registry development within the region. Key Content and Findings: The only countries possessing a national registry in West Africa are Cape Verde and the Republic of Gambia. Benin, Burkina Faso, Cote d’Ivoire, Ghana, Guinea, Mali, Niger, and Nigeria possess sub-national registries, namely hospital-based and population-based registries with minimal catchment areas. In Ghana, the Kumasi Cancer Registry represents the country’s only population-based registry. Partnerships with international organizations and participation in regional capacity building efforts have facilitated its maintenance of operations in cancer continuous data collection. Despite this, barriers to its expansion have included limited funding, challenges with data linkage across data collection sites, and a lack of an automatized electronic data collection system for cancer cases. Conclusions: Implementation of the GBCI framework crucially depends on routinely collected cancer data covering a country’s entire population, highlighting the importance of national cancer registries. To date, all countries in West Africa, except two, lack national cancer registries and face barriers to implementation, including limited mortality data access, low funds, and difficulties with data linkage, as highlighted by the case study of Ghana. Future work should be dedicated towards (I) automatizing and standardizing the data collection systems among sub-national registries and (II) pursuing structured regional capacity-building training on robust cancer registration practices within West Africa.

Background/Objectives: To overcome the side effects of conventional cancer treatment, multifunctional nanoparticles with image-guidance properties are increasingly desired to obtain enhanced therapeutic efficacy without any toxicity of the treatment. Herein, we introduce the potential of Polydopamine Radioimmunotherapy with Image-guided Monitoring and Enhanced (drug) Release System (PRIMERS) to meet the challenges of currently used cancer therapy. Methods: The PDA nanobowls were synthesized using an emulsion-induced interfacial anisotropic assembly method followed by surface modification with high-Z material to obtained the final product PRIMERS. Results: The engineered multifunctional nanosystem “PRIMERS” could serve as fiducial markers with the potential for use in combination cancer therapy. By leveraging the advantages of the excellent surface functionalization capability of PDA, the anisotropic nanostructure (PDA nanobowls) has been successfully functionalized with gadolinium, which shows strong MRI contrast signal both in vitro in phantom and in vivo in animals. The results of anti-cancer drug loading and releasing efficiency of these functionalized nanobowls are presented. Moreover, the gadolinium-coated PDA nanobowls demonstrate the capacity for loading immunotherapy drugs (Anti-CD40) with activated release in acidic pH levels characteristic of the tumor microenvironment, with enhanced release following administration of radiation therapy in vitro. Conclusions: Overall, the results highlight the potential of this new technology for combining radiotherapy with activated image-guided drug delivery, which offers broad opportunities to overcome current challenges in cancer treatment.

Pre-clinical animal studies evaluating the ‘flash effect’ caused by ultra-high dose rate (>=40Gy/s) favorably spares normal tissue from radiation-caused toxicity while maintaining anti-tumor effect like conventional (CONV) radiation. The goal of this study is to leverage an immune response resulting from the treatment combination of flash radiotherapy (Flash-RT) and LIFE (liquid immunogenic fiducial eluter) biomaterial incorporating an anti-mouse CD40 monoclonal antibody to enhance the therapeutic ratio in pancreatic cancer. Methods: A small animal FLASH radiation research platform (FLASH-SARRP) was utilized to deliver both ultrahigh and CONV dose-rate irradiation to treat syngeneic subcutaneous pancreatic tumors generated in 8-10-week-old female C57BL6 mice. The efficacy of FLASH versus CONV radiotherapy (RT) at varying doses of 5, 8, 10, and 15Gy delivered in a single fraction was evaluated by assessing tumor growth and mice survival over time or comparing tumor weight at 10 days post-treatment. Results: Similar tumor control capability was observed from both FLASH and CONV RT compared to the control group. However, longer survival was observed for the FLASH group at 5Gy compared to CONV and control at either 5Gy, 10Gy, or 15Gy dose. Multiplex immunofluorescence and immunohistochemistry results showed higher T-cells infiltration within the combination of RT (either FLASH or CONV) and LIFE biomaterial-treated tumors compared to the control cohort. Conclusions: This animal study serves as an impetus for future studies leveraging the immune response using the combination of FLASH and LIFE Biomaterial to enhance the efficacy of pancreatic cancer treatment.