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 Table of Contents  
REVIEW ARTICLE
Year : 2018  |  Volume : 32  |  Issue : 2  |  Page : 81-83

Nanotechnology in oncology: A concern on its unwanted effects and ethics


1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Biological Science, Joseph Ayobabalola University, Ilara-Mokin, Nigeria

Date of Web Publication25-Oct-2018

Correspondence Address:
Dr. Sora Yasri
KMT Primary Care Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jms.jms_4_18

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  Abstract 

Nanotechnology is the new advent in science at present. The medical nanotechnology is present useful tool for the management of several diseases. For cancer, the application of nanotechnology can be seen, and it is approved for the usefulness. On the other side of the coin, there are also unwanted effects of nanotechnology application in oncology. In this article, the authors review and discuss on the possible unwanted adverse effects of nanotechnology in oncology. The specific ethical concern for nanotechnology in oncology is also mentioned. Interesting quote from leading ethicists and case studies are also presented in this short article.

Keywords: Adverse, cancer, ethics, nanotechnology, oncology


How to cite this article:
Yasri S, Wiwanitkit V. Nanotechnology in oncology: A concern on its unwanted effects and ethics. J Med Soc 2018;32:81-3

How to cite this URL:
Yasri S, Wiwanitkit V. Nanotechnology in oncology: A concern on its unwanted effects and ethics. J Med Soc [serial online] 2018 [cited 2018 Nov 17];32:81-3. Available from: http://www.jmedsoc.org/text.asp?2018/32/2/81/244132


  Introduction Top


Nanotechnology is the new advent in science at present. The medical nanotechnology is present useful tool for the management of several diseases. For cancer, the application of nanotechnology can be seen, and it is approved for the usefulness. The applied of the nanomaterials-based diagnostic, and therapeutic tool helps better cancer management.[1] New nano-based drug and target therapy are the best examples of applied nanotechnology in oncology at present.[1],[2],[3] On the other side of the coin, there are also unwanted effects of nanotechnology application in oncology. In this article, the authors review and discuss on the possible unwanted adverse effects of nanotechnology in oncology. The specific ethical concern for nanotechnology in oncology is also mentioned. Interesting quote from leading ethicists and case studies is also presented in this short article.


  Possible Unwanted Adverse Effects of Nanotechnology in Oncology Top


The possible adverse effect of the nanotechnology in oncology should be mentioned. The safety of the nanotechnology has to checked.[4] At present, several international organizations including to Food and Drug Administration (FDA), Environmental Protection Agency, and Department of Agriculture and National Institutes of Health mentioned for the requirement for monitoring the adverse effect of the merging nanotechnology.[5],[6] The toxicology of nanomaterials becomes an interesting issue in the present day.

Indeed, there are many possible adverse effects of nanoparticle. The good example is the spermatoxicity[7] and hematotoxicity.[8],[9] Although the nanotechnology is proposed for usefulness in reducing toxicity in cancer treatment,[10] the risk from the toxicity directly related to the nanoparticle should not be forgotten.

In addition, while the nanoparticle is widely used as tool for cancer treatment at present, the great concern is on the possible carcinogenicity of the nanoparticle. In fact, the genetic aberration due to exposure to nanomaterial is possible. This is already approved in the in vitro cell culture in the report by Zhang et al.[11] Singh et al. noted that there is a need to assess the genotoxicity of genotoxic potential of presently available nanomaterials.[12] Singh et al. noted that several nanomaterials such as metal nanoparticles, metal oxide nanoparticles, quantum dots, fullerenes, and fibrous nanomaterials might cause nucleic acid abnormality and this is the underlying mechanism of nanogenetoxicology.[12] Based on the fact that there is a possible genotoxicity effect, the next important question is on carcinogenesis process. The possible carcinogenesis of nanomaterials is little mentioned. The safety of the presently used nanomaterials has to be verified.[13] There are some interesting reports on the carcinogenesis of nanomaterials indicating the great risk of carcinogenesis.[14],[15],[16],[17] The good evidence of nanomaterial-induced carcinogenesis is the very small nanoparticles that can enter into the human body through respiration. Shen et al. concluded that nanoparticles could be uptaken by endocytosis process, and it can further directly or indirectly cause damage to genes.[18] The mentioned damages can interrupt the physiological course of cell cycle and result in instability of the genome which might further induce gene mutation or chromosome aberration and finally lead to cellular death or malignant transformation.[18]

Finally, there are already available nano-based chemotherapy. The adverse effect of those new drugs is still observable. Focusing on the pegylated liposomal doxorubicin (PLD) namely Doxil®, the first FDA-approved nano-drug in 1995, the adverse effect due to its doxorubicin can still be seen.[19] Ansari et al. reported that the most important side effect of PLD was dermatotoxicity although the observed adverse dermatological side effects were not serious.[20] Gusella et al. reported an interesting observation regarding this new nano-based chemotherapeutic drug for relationship between age and exposure, decreased DNA repair ability, and increased dermatotoxicity.[21]


  Ethical Concern for Nanotechnology in Oncology: A Topic that is Little Mentioned Top


The ethical issue is an important concern for any new technology including to the new nanotechnology that should not forgotten. There are many important ideas from famous ethicists that will be further mentioned and quoted. Jameel noted that “Every technology also has a dual use, which needs to be understood and managed to extract maximum benefits for mankind and the development of civilization.[22]” Naurato and Smith also mentioned that “professionals have had relatively little contact with moral and legal theory in light of these developments and particularly since they represent the forefront of new medical innovations.[23]”Hence, we need to follow the ethical guideline in using new nanotechnology. The international collaboration to deal with the ethical issue is interesting. A multidisciplinary collaboration to create policies is required for help develop and implement of new sustainable nanotechnology.[24]

For the application of nanotechnology in oncology, ethical issue is very important. The nanotechnology in oncology has to be used in controlling diagnosis or treatment of cancer. For diagnosis, the special concern is on the privacy of the cancerous patient. For treatment, the use of nonlicenced new nanodrug or nanotreatment for management of the patients becomes a big ethical problem. Indeed, in nanotrials in oncology, the patients usually get risk during exposure to new nano-object that is still unknown for its long-term effect. The protection of patient's right is I needed, but it is usually violated in real practice. In oncology, ones who participate in any clinical trial have to get complete full nondisguised information. However, the nanotrial in oncology usually contains myths. King stated that data on “risks of harm, translational uncertainty, ambiguities in potential direct benefit, and long-term follow-up” must be prepared and given to all volunteer participants.[25] In judgment of a nanotrial in oncology, the use of basic ethical principles “autonomy, beneficence, nonmaleficence, justice” is required.[26] The good example is the recent report on ethical evaluation on the study on “nanoparticle-based therapy against brain tumors termed magnetic fluid hyperthermia.[26]

Disguising or incomplete data during trial of new nano-drug in oncology are considered unethical, and it is a direct violation of the basic informed consent principle.[25],[27],[28] The extension ethical concern of effect to the third party in external environment is also raised.[29] Jotterand and Alexander noted that “We argue that our lack of data concerning long-term effects and risks of nanoparticles on human health and the environment could undermine the process when it comes to weighing the risks against the benefits.[30]” As noted by King,[25] the first-in-human research on is usually an ethical challenge. King note that “Some nanomedical technologies have additional characteristics that should be addressed including: defining and describing nanomedical interventions; bystander risks; the therapeutic misconception; and a decision-making context that includes both common uses of nanomaterials outside medicine and persistent unknowns about the effects of nanosize.[25]

In oncology, there are already some ethical case studies. The most famous case is on the “pazopanib.” Giving the reason that “The Committee has come to the conclusion that author Kadam has knowingly and intentionally falsified and/or fabricated results by manipulating LCMS/MS peak area data to smooth kinetics and/or alter statistical significance. The standard curve for the drug pazopanib was falsified to make it appear linear.” A report on the new nanodrug that can be used for the management of sarcoma was retracted from publication in “J Control Release.”


  Conclusion Top


It can conclude that there are possible adverse effects of nanotechnology that is widely used at present. While the nanomaterials are useful for cancer management, the possibilities of toxicity and carcinogenicity exist. The control of the nanotechnology is needed and the basic nanoethics principle has to be followed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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Wiwanitkit V, Sereemaspun A, Rojanathanes R. Effect of gold nanoparticle on the microscopic morphology of white blood cell. Cytopathology 2009;20:109-10.  Back to cited text no. 8
    
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Singh N, Manshian B, Jenkins GJ, Griffiths SM, Williams PM, Maffeis TG, et al. NanoGenotoxicology: The DNA damaging potential of engineered nanomaterials. Biomaterials 2009;30:3891-914.  Back to cited text no. 12
    
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Ansari L, Shiehzadeh F, Taherzadeh Z, Nikoofal-Sahlabadi S, Momtazi-Borojeni AA, Sahebkar A, et al. The most prevalent side effects of pegylated liposomal doxorubicin monotherapy in women with metastatic breast cancer: A systematic review of clinical trials. Cancer Gene Ther 2017;24:189-93.  Back to cited text no. 20
    
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Gusella M, Bononi A, Modena Y, Bertolaso L, Franceschetti P, Menon D, et al. Age affects pegylated liposomal doxorubicin elimination and tolerability in patients over 70 years old. Cancer Chemother Pharmacol 2014;73:517-24.  Back to cited text no. 21
    
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[PUBMED]  [Full text]  
23.
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