Nanotheranostics Utilizing 5-Fluorouracil in Cancer Management: An In-Depth Analysis of Efficacy, Safety, and Diagnostic Applications.

Introduction: The utilisation of nanocarriers for drug delivery in cancer treatment is further enhanced by incorporating diagnostic functionality. These dual-purpose nanotheranostic agents (NTAs), serve as a single platform capable of both treatment and real-time monitoring of cancer progression simultaneously. The wide range of materials utilised in constructing NTAs may lead to significant variations in their properties. Therefore, a systematic review was conducted to consolidate current NTAs incorporating 5-fluorouracil (5FU) and elucidate their differences in toxicity, efficacy, and imaging performance. Methods: Medline and Embase databases were searched up to 18th March 2022 to include articles with keywords of "cancer," "theranostics," "nanoparticle," "in vivo" and "fluorouracil" in combination. Publications were screened if they met the following criteria: original research involving 5FU, utilising an animal cancer model, and reported outcomes related to efficacy, toxicity, or diagnostics. Results: Nine studies were included in the analysis, with 44.4% developing NTAs using inorganic materials, mainly gold nanoparticles. Another 33.3% developed NTA using the hybrid of organic and inorganic materials while two studies used organic material only to achieve nanotheranostic properties. The 5FU-NTAs were categorised based on their functions: active targeting only (50.0%), thermal ablation only (33.3%) and a combination of both (16.67%). Irrespective of the materials used, all functionalised NTAs consistently outperformed the non-functionalised nanoparticles, evidenced by a tumour volume reduction exceeding 40% compared to the control. All NTAs did not result in significant toxicity based on the body weight change. For imaging, the NTAs tagged with targeting moiety achieved maximum tumour accumulation faster (within 6 hours). Conclusion: The functionalised NTAs hold promises for all-in-one management of advanced cancer. To further improve the quality of current preclinical practice, this review proposed a checklist of parameters (PICANT) to recommend researchers for nanoparticle testing in animal cancer studies. [ABSTRACT FROM AUTHOR]