Nanomedicine Targeting Cancer-Associated Fibroblasts in Prostate Cancer: From Biological Mechanisms to Integrated Theranostic Strategies - PubMed

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Prostate cancer (PCa) is the second most common malignancy in men globally, with advanced stages showing tumor heterogeneity, metastasis, and therapy resistance.
Cancer-associated fibroblasts (CAFs) are key stromal cells in the PCa tumor microenvironment (TME), driving tumor progression, metastasis, and resistance to treatment.
Nanomedicine offers a transformative approach for targeting CAFs, utilizing engineered nanomaterials for precise drug delivery, improved bioavailability, and theranostic (diagnostic + therapeutic) capabilities.
The review explores CAF biology in PCa, including their origins, activation, markers (e.g., α-SMA, FAP), heterogeneity, and interactions with cancer cells, immune cells, and the extracellular matrix (ECM).
Nanomaterial-based strategies for CAF targeting include depletion, reprogramming, and ECM remodeling, alongside theranostic platforms like molecular imaging probes (e.g., 68Ga-FAPI) and image-guided delivery systems.
Challenges such as CAF heterogeneity and nanomaterial biosafety are discussed, with future directions including gene-editing, multi-stimuli-responsive systems, and immunotherapy combinations.

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