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Breast cancer is a carcinoma of mammary glands, which starts off as abnormal proliferation of ductal cells. This could, then, become either benign tumours or metastatic carcinomas. It is one of the most common causes of deaths because of cancer, and is one of the most common types of cancer in women in the whole world. India along with the US and China accounts for one-third of the breast cancer burden. The breast cancer carcinogenesis is attributed to epigenetics, which is the study of the reversible changes in the phenotype without any change in the DNA sequence. Genes, which are concerned with proliferation, anti-apoptosis, invasion, and metastasis, have been seen undergoing epigenetic changes in breast cancer. Cancer can be caused either by global hypomethylation (causing activation of oncogenes and leading to chromosomal instability) or by locus-specific hypermethylation (causing repression of gene expression and genetic instability due to inactivation of DNA repair genes). Other epigenetic mechanisms involved in carcinogenesis are histone modification and nucleosomal remodeling.

In the present study, thymoquinone (TQ)-encapsulated chitosan- (CS)-coated poly(d,l-lactide-co-glycolide) (PLGA) nanoparticles (NPs) were formulated using the emulsion evaporation method. NPs were optimized by using 33-QbD approach for improved efficacy against breast cancer. The optimized thymoquinone loaded chitosan coated Poly (d,l-lactide-co-glycolide) nanoparticles (TQ-CS-PLGA-NPs) were successfully characterized by different in vitro and ex vivo experiments as well as evaluated for cytotoxicity in MDA-MB-231 and MCF-7 cell lines. The surface coating of PLGA-NPs was completed by CS coating and there were no significant changes in particle size and entrapment efficiency (EE) observed. The developed TQ-CS-PLGA-NPs showed particle size, polydispersibility index (PDI), and %EE in the range between 126.03&ndash, 196.71 nm, 0.118&ndash, 0.205, and 62.75%&ndash, 92.17%. The high and prolonged TQ release rate was achieved from TQ-PLGA-NPs and TQ-CS-PLGA-NPs. The optimized TQ-CS-PLGA-NPs showed significantly higher mucoadhesion and intestinal permeation compared to uncoated TQ-PLGA-NPs and TQ suspension. Furthermore, TQ-CS-PLGA-NPs showed statistically enhanced antioxidant potential and cytotoxicity against MDA-MB-231 and MCF-7 cells compared to uncoated TQ-PLGA-NPs and pure TQ. On the basis of the above findings, it may be stated that chitosan-coated TQ-PLGA-NPs represent a great potential for breast cancer management.

Colon cancer is one of the most commonly diagnosed malignancies, which begins as a polyp and grows to become cancer. Diosmin (DS) and naringenin (NR) are naturally occurring flavonoids that exhibit various pharmacological activities. Although several studies have illustrated the effectiveness of these flavonoids as anti‑cancerous agents individually, the combinatorial impact of these compounds has not been explored. In the present study, the combined effect of DS and NR (DiNar) in colon cancer cell lines HCT116 and SW480 were assessed by targeting apoptosis and inflammatory pathways. The MTT assay was used to evaluate the effect of DiNar on cell proliferation, while Chou‑Talalay analysis was employed to determine the combination index of DS and NR. Moreover, flow cytometry was used to monitor cell cycle arrest and population study. The onset of apoptosis was assessed by DAPI staining, DNA fragmentation, and Annexin V‑fluorescein isothiocyanate/propidium iodide (Annexin V‑FITC/PI). The expression levels of apoptotic pathway markers, Bcl‑2, Bax, caspase3, caspase8, caspase9 and p53, and inflammatory markers, NF‑κβ, IKK‑α and IKK‑β, were assessed using western blotting and reverse transcription‑quantitative PCR. These results suggested that DiNar treatment acts synergistically and induces cytotoxicity with a concomitant increase in chromatin condensation, DNA fragmentation and cell cycle arrest in the G0/G1 phase. Annexin V‑FITC/PI apoptosis assay also showed increased number of cells undergoing apoptosis in the DiNar treatment group. Furthermore, the expression of apoptosis and inflammatory markers was also more effectively regulated under the DiNar treatment. Thereby, these findings demonstrated that DiNar treatment could be a potential novel chemotherapeutic alternative in colon cancer.

Biological studies have always relied on visual data and its precise interpretation. Bio-imaging is an integral part of cancer research as well as the diagnosis and treatment of various cancers. Cancer research employs the various bio-imaging techniques of fluorescence microscopy like confocal microscopy, FRET, FRAP, TPEF, SGH, etc. to study the complexity and characteristics of different cancer cells. The development of live-cell imaging has also helped in understanding the important biological processes which differentiate cancer cells from their environment. Advancement in the field of cancer diagnosis has taken place with the development of sophisticated radiology techniques like MRI, CT scans, and FDG-PET. Also, the development of novel nanotechnology-based probes has improved the quality of both cancer research and diagnosis. In this chapter, the authors summarize some of the bio-imaging techniques which are being used in the field of cancer studies.

Cancer is portrayed as a group of disease characterized by alteration in the normal regulation of cell growth by the successive acquisition of genetic, somatic, and epigenetic alteration. Synthetic drugs are single targets while natural products are multi-targeted to prevent cancer. NF-κB is persistently active in a number of disease states, including cancer, and therefore has a critical role in cancer development and progression. It also provides a mechanistic link between inflammation and cancer and is a major controlling factor resistant to apoptosis in both pre-neoplastic and malignant cells. Importantly, NF-kB and the signaling pathways that mediate its activation have become attractive targets for the development of new chemopreventive and chemotherapeutic approaches. Natural antioxidants have been shown to possess chemopreventive and chemotherapeutic potential via targeting NF-κB signaling, among which tea polyphenols have been studied extensively. In this chapter, the authors summarize the regulation of NF-κB pathway by green tea polyphenols in different cancer types.

Cancer immunotherapy has become a powerful clinical strategy as well as an established pillar for the treatment of cancers to improving the prognosis of many cancer patients with a broad variety of solid tumors as well as blood cancers. The primary goals of immunotherapy are (a) to increase anti-tumor response, (b) decrease the immune suppression, and (c) to enhance the immunogenicity of tumors. This chapter aims to discuss the mechanism and different types of immunotherapies used for different cancers. It will also focus on recombinant products including immunostimulants, immunotoxins, antibodies, fusion proteins, engineered cytotoxic T cells, engineered immunocytokines, vaccines, checkpoint inhibitors, CAR T-cell therapy, and nanomedicine. Although immunotherapy has a rare side effect, it is not fully understood. The development of new strategies has been on the clinical trial to enhance the benefit of cancer patients to meet with challenges of limited efficacy and/or toxicity.

Cancer has been a worldwide topic in the medical field for a very long time. As angiogenesis is essential for tumor growth and metastasis, controlling tumor-associated angiogenesis is a promising tactic in limiting cancer progression. In cancer patients, multidrug resistance (MDR) is most widely used phenomenon by which cancer acquired resistance to chemotherapy. This resistance to chemotherapy occurs due to the formation of insulated tumor microenvironment which remains a major hurdle in the cure of various types of cancer. The mechanisms that cause malignant growth of cells include cell cycle control, signal transduction pathways, apoptosis, telomere stability, and interaction with the extracellular matrix. This chapter focuses on current strategies to suppress tumor angiogenesis for cancer therapy, various mechanisms involved in the development of MDR in cancer cells, which in turn will help us to identify possible strategies to overcome these MDR mechanisms and a variety of procedures that involves targeting apoptotic and telomerase pathways to suppress tumor progression.

Several modern treatment procedures have been received to battle malignancy with the point of limiting lethality. Phytopharmaceuticals are auxiliary metabolites of plant origin which exclusively contain one or more substances as active ingredients or might be a blend of them. Analysts have excitedly attempted to diminish the lethality of current chemotherapeutic agents either by consolidating them with herbals or in utilizing herbals alone. Synergy is a procedure where a few substances participate to reach a consolidated impact that is more prominent than the entirety of their different impacts. It may be viewed as a characteristic straight technique that has developed ordinarily by nature to acquire more efficacies at a low cost. This chapter aims to present the fundamental mechanism of the activity of phytochemicals in combination therapy. This chapter additionally features the remarkable synergistic impacts of plant-drug cooperation with an emphasis on anticancer strategies.

Cancer is a major killer disease caused by uncontrolled growth and invasion of cells. Apoptosis is the cell's natural mechanism of death, which maintains tissue homeostasis. Any mutation that disturbs the apoptotic pathway leads to deregulated proliferation, resistance, and evasion of apoptosis. This evasion is one of the hallmarks of malignant developments. Apoptosis takes place via two distinct pathways i.e. the intrinsic and the extrinsic pathways. These pathways use cleaved caspases to execute apoptosis which in turn cleave many downstream proteins to kill the cells. They can also be inhibited through various means that include up-regulation of anti-apoptotic and down-regulation of pro-apoptotic factors. The authors here aim to impart a comprehensive understanding of the biochemical characteristics of these pathways that render scientists target these pathways and assess apoptosis restoring abilities of the novel drugs and natural products for cancer treatment.

In a conventional oral or intravascular drug delivery approach, therapeutic factors are distributed throughout the body and only a limited part of the drug reaches to tumor site. Packaging of cytotoxic agents in drug delivery systems like nanoparticles could enhance its delivery to specific targets in the tumors and could be potential candidate for therapeutics advancement. Targeted drug delivery holds the potential to overcome the present therapeutics of cancer by selective delivery of an arbitrary amount of drug at the tumor site. Loading of cytotoxic agents in drug delivery systems could enhance its delivery to specific targets based on strategy to reach the tumor site. This chapter explores the detailed of innovative methods of drug delivery, challenges of targeted drug delivery, and their implications.

In this chapter, the authors first review nano-devices that are mixtures of biologic molecules and synthetic polymers like nano-shells and nano-particles for the most encouraging applications for different cancer therapies. Nano-sized medications additionally spill especially into tumor tissue through penetrable tumor vessels and are then held in the tumor bed because of diminished lymphatic drainage. This procedure is known as the enhanced penetrability and retention (EPR) impact. Nonetheless, while the EPR impact is generally held to improve conveyance of nano-medications to tumors, it in certainty offers not exactly a 2-overlay increment in nano-drug conveyance contrasted with basic ordinary organs, bringing about medication concentration that is not adequate for restoring most malignant growths. In this chapter, the authors likewise review different obstructions for nano-sized medication conveyance and to make the conveyance of nano-sized medications to tumors progressively successful by expanding on the EPR impact..

Cancer continues to be one in all the leading reasons for death worldwide. The mean cancer survival through standard therapeutic strategies has not been significantly improved over the past few decades. Hence, alternate remedies are needed to treat this terrible disease. Recently, natural compounds present in the plants, i.e. phytochemicals have been widely exploited for their anticancer potential. Phytochemicals may exhibit their anticancer activity through targeting different cancer cell signalling pathways, promoting cell cycle arrest and apoptosis, regulating antioxidant status and detoxification. Despite their excellent anticancer activity, the phytochemicals are limited by their low aqueous solubility, poor bioavailability, and poor penetration into cells, hepatic disposition, narrow therapeutic index and rapid uptake by normal tissues. Therefore, to address these challenges, the scientific community has shifted its significant interests towards nanocarriers-based delivery of phytochemicals due to their ability to enhance aqueous solubility, and bioavailability, specific tumour cell/tissue targeting, improved cellular uptake, reducing doses of phytochemicals and achieving steady-state therapeutic levels of the phytochemicals over an extended period of time. Additional advantages include excellent blood stability, multifunctional design of nanocarriers and improvement in anticancer activities. This review aims to summarise recent progress in phytochemical based nanomedicines for effective treatment of cancer.