Medicine is going small – nano-small in fact. This is medicine practiced on the scale of less than 100 nanometres, tiny when compared with the diameter of a human hair, which is 80,000 nanometres. But while nanomedicine is on the small side, it promises to be big business.

Nanomedicine is the application of nanotechnology to healthcare, and encompasses a number of specialities from technology and engineering to biology and mathematics. Such medicines have already been used to alter the behaviour of drug substances – including absorption, metabolism and reducing side effects – but new developments are really taking off, and estimates suggest the market could grow to $130.9 billion by next year, says Andrew Owen, chair of the British Society for Nanomedicine. 

Targeted nanomedicines are one of the recent breakthroughs – there are clinical trials underway that specifically target cancer cells and HIV, leaving healthy cells intact, Owen notes. The benefits are clear. “Nanomedicine leads to a fundamental shift in how we develop drugs by engineering the biodistribution into the nanoparticle while letting the chemists focus on biological activity,” says Andrew Hirsch, president and chief executive of nanomedicine platform company BIND Therapeutics.   

But more than that, nanomedicine also promises early diagnosis and will even lead to disease prevention, says Inês Mendes Pinto, health unit coordinator at the International Iberian Nanotechnology Laboratory. “Diagnostic nanomedicine will allow us to unravel the mechanism of cell transformation, for example in cancer, and thus enable us to detect early, or even prevent, cell transformation into a malignant state.” These insights are also likely to lead to improved medical devices and treatments tailored to each person’s profile, which will ultimately reduce healthcare costs.

And pharma companies are pricking up their ears. So far, Amgen, AstraZeneca, Merck, Pfizer and Roche have all forged partnerships with BIND Therapeutics, which has developed Accurins, targeted nanoparticles that can use payloads such as small molecules, peptides, proteins and nucleic acids. Some of these partnerships use the technology to evaluate drugs that have failed in the clinic because of therapeutic index issues, others use it to target cells or organs that have been historically difficult to treat, says Hirsch. “These approaches are early and have only scratched the surface of what the technology can do.” 

Key to nanomedicine’s success will be the ability to produce at scale. “For human use, benchtop work is not enough,” says Hirsch. “The FDA needs proof that multiple batches are reproducible over time and at a scale to serve the marketplace,” and consistent manufacturing at scale could be an issue.

The other challenge is making nanomedicine cost-effective, particularly at scale – though improved targeting, efficacy and reduced side effects should balance this out and reduce healthcare costs, says Mendes Pinto. Meanwhile, safety concerns around nanomaterials are sometimes raised, although in 2006 the EMA said there was no immediate need for specific regulation relating to nanomedicines. 

The future is bright for these innovative therapeutics, and Hirsch, for one, believes nanomedicines will become the new best-in-class. While most research has been directed towards cancer, Matthew Tirrell, Pritzker director and professor at the University of Chicago’s Institute for Molecular Engineering, says this will soon be matched by studies into atherosclerosis, neurodegenerative diseases, autoimmunity and synthetic vaccines against pathogens. 

Nanomedicine also promises to open the way to personalised medicine, says Mendes Pinto, and it will ultimately converge with other technologies such as miniaturised wireless communication, which will lead to more opportunities like disease-specific and continuous monitoring. “Nanotechnology,” she says “is set to change the way doctors practice medicine”. 

This article was published in the April issue of PharnaTimes Magazine. You can read the full magazine here