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    Contents lists available at ScienceDirect
    Nano Today
    News and Opinions
    Challenges in molecular diagnostic research in cancer nanotechnology
    Giulio Caracciolo a , Hojatollah Vali b , Anna Moore c,∗, Morteza Mahmoudi c,d,∗ a Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161 Rome, Italy
    b Department of Anatomy and Cell Biology and Facility for Electron Microscopy Research, McGill University, Montreal, Quebec, H3A 0C7, Canada c Precision Health Program, Michigan State University, East Lansing, MI, USA d Department of Anesthesiology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
    Article history:
    Diagnostic nanotechnology
    Therapeutic nanotechnology
    Social burden
    Development of robust cancer prevention strategies have the capacity to reduce the need for therapeutic products, relieve patient’s suffering and alleviate the crushing financial burden for both patients and their families. Therefore, the obvious choice that would benefit the largest number of people is to realign the importance and prioritization of diagnostics alongside therapeutics. However, entrepreneurs and policy-makers are more inclined to invest in manufacturers of therapeutics, which produce much higher revenues compared to diagnostics companies. The central aim of this SQ-109 opinion article is i) to identify the reasons for this chasm gap between therapeutic and diagnostic approaches in cancer research; and ii) to draw the attention of researchers, entrepreneurs, and policy-makers to the importance and potential promises of diagnostic approaches in lowering the social burden and cost of cancer.
    The research in the area of early diagnostics and disease detec-tion is “underdeveloped” compared to the therapeutics, which poses a serious concern in the age of precision health when the overwhelming efforts of forward-looking scientists are directed towards shifting the medicine from being “reactive” (i.e. responding to a disease) to “pro-active” (i.e. focusing on prediction, prevention and early detection). Here we attempt to analyze this discrepancy in detail and define the underlying reasons that create the gap between diagnostic and therapeutic approaches.
    Nanotechnology-based diagnosis and treatment of cancer play key roles in overcoming the limitations of conventional methods by providing more accuracy and precision (e.g., by targeting at cellular scale and sustained delivery of desired biomolecules [1]). One would, therefore, expect that a nano-based diagnostic and treatment approach should be a priority instead of conventional intervention. In reality, however, the focus of clinical, academic and industrial research is on advancing conventional therapeutics, while nano-based diagnostics and treatment continue to be less appreciated. It appears that research in the field of nano-biomedical
    ∗ Corresponding authors at: Precision Health Program, Department of Radiology, Michigan State University, East Lansing, MI, USA.
    cancer diagnostic and treatment is underfunded, as reflected by the lower number of scientific publications in this field compared to conventional cancer therapeutics. A recent cursory literature search in PubMed using “cancer diagnostic” as a keyword revealed 978 references, while the search for “cancer therapeutics” produced 6694 references.
    Diagnostic vs. Therapeutic nanotechnology: A scientific point of view
    The reports published by the World Health Organization (WHO) [2] and by the European Federation of Pharmaceutical Industries and Associations [3] identify cancer as one of the most common diseases, with an annual increase of over 14 million new cases lead-ing to 8.8 million deaths per year worldwide. Fortunately, in many cases, the causes of cancer (at least from genomic point of view) have been identified and new strategies for treatment have been developed. The field of cancer therapeutics produced over 323,000 articles published over the last ten years with an average annual growth rate (AAGR) of 3.9% (Fig. 1a). Despite these advancements, no other disease is expected to grow faster than cancer. The rates of incidence and mortality is expected to exceed 70% by 2040 [4]. This shocking prediction is based on the series of concomitant factors such population aging, environmental conditions, gender, lifestyle, diet, the intestinal microflora and molecular heterogeneity. The only alternative solution to reverse the current trend is to promote