ABSTRACT
PFPE: Perfluoropolyether; PFTE: Perfluoro-tert-butyl ether; PFC: Perfluorocarbon; PFC-NE: Perfluorocarbon-Nanoemulsion; PFCE: Perfluoro-15-crown-5-ether; PFOB: Perfluorooctylbromide; PFDB: Perfluorodecylbromide; HC-Hydrocarbon; DFNE: Drug-free nanoemulsions; CXBNE: Celecoxib nanoemulsion
Theranostic nanomedicine aims to personalize treatment by combining therapeutics with diagnostics into one nanosystem. Variability is expected during an individual patient‘s course of disease progression and treatment because the human body
presents dynamic pathophysiology. The ability to move treatment along the path of these changes would allow a patient the opportunity to recieve exactly the treatment needed, no more and no less. Therefore, this would contribute to better understanding of the disease and the effect of the drug, as well as the ability to adapt the treatment to follow these changes in every patient. Ideally, a diagnostic agent in a theranostic nanomedicine works in synergy with the therapeutic moiety (drug) by providing input on drug reaching its anatomical, cellular and/or molecular target, feedback on drug effects on the underlying pathology and therapeutic efficacy and/or side effects. Further, by seeing the changes of pathophysiology as a drug is administered in real time, the drug treatment can be fine-tuned to match these changes. The diagnostic should also provide clues on the mechanisms involving the drug target and indirectly help finetune both the dose and dosing regimen. Therefore, an ideal theranostic nanomedicine provides an opportunity to personalize treatment during the entire course of therapy in an individual patient. To achieve these goals, theranostic nanomedicine must grow beyond smart engineering and into pharmaceutical development. Adding an imaging agent or drug to an existing drug delivery system or imaging platform is only a partial solution and does not move the system closer to personalized treatment. The two entities have to work in synergy, which can be achieved if the whole theranostic nanosystem is viewed from a lense of drug design, and that vision must be maintained from the inception of the nanosystem through all steps of development until reaching a patient. For a pharmaceutical scientist, theranostic nanomedicines are future medicines, meeting the same standards of effectiveness and safety as all other clinically approved treatments. Figure 14.1 summarizes the key goals for theranostic nanomedicines developed today.
