Most method emerged as new frontier in

Most lethal cancers are associated withdistant metastatic spread and often require chemotherapy, radiation therapy,immunotherapy and hormonal therapy among other systemic treatments.

Although regardedas effective measures of destroying rapidly metastasizing cancer cells, thesetreatments often do a lot more to the body, than just cure cancer. Serious sideeffects frequently accompany these therapies, mainly because of theirnon-specific targeting nature, that result in the destruction of healthy cells,besides the regular cancer cells. This is particularly perilous when the canceroriginates in bone marrow, which is a niche of haematopoietic stem cells andtherefore it becomes quite challenging for chemotherapeutic drugs to target andselectively destroy the cancer cells.    Incontrast, photodynamic therapy or phototherapy (PT) involves a non-invasiveprocedure for destroying cancer cells, specifically targeting the cancer cellsvia a precise spatiotemporal control. Traditional phototherapy, as the namesuggests, utilizes light from external sources to activate the photosensitizerdrugs, leading to cell death. This method emerged as new frontier in treatingskin cancers but the problem arises in case of deep-seated tumours. In suchcases, external light cannot penetrate the skin and reach the underlyingtissues due to their being absorbed and scattered by the tissue system.

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Due tothe limited penetrance of external light, PT has been useful in treating only surfacelesions.To overcome this limitation, researchers atthe Washington School of Medicine have designed a set of experiments to preparean optimized system that uses Cerenkov Radiation (CR)-mediated conversion ofchemotherapeutics to phototherapeutics. An orthogonal cancer targeting strategyusing nanomicelles was developed. Targeted delivery of a radionuclide and thedrug is necessary to enable co-localization and subsequent CRIT (CerenkovRadiation Induced Therapy).The radionuclide used in this case is 18-FDG whichenters cancer cells through overexpressed Glut transporters  on cancer cells. 18-FDG acts as a pointsource of photoelectronic energy and can stimulate any photoactive material inits close proximity.

It was used to photoactivate titanocene (thephotosensitizer) through Cerenkov radiation, causing cell death. Titanoceneenters the cancer cells through the alpha-4-beta-1 receptors on the cellsurface. The combination of  alpha-4-beta-1and Glut receptors is not expressed in any healthy haematopoietic cell in thebone marrow, hence they remain unaffected.The CRIT thus transforms chemotherapeuticdrugs to phototherapeutic ones using radionuclides that emit cerenkov radiationand offers a non-invasive technique of treating a large number of previously inaccessibledeep-seated rapidly growing cancer cells; it will definitely be a boon for anumber of cancer patients who need to undergo regular chemotherapy andradiation-induced therapies so as not to succumb to the deadly disease. 

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