Swarms: The Next Frontier for Cancer Nanomedicine

Nanomedicine refers to medical products developed using nanotechnology and has the potential to radically change how we diagnose and treat cancer. While the use of nanomedicines has increased in the clinic dramatically, problems persist over the lack of an agreed definition, creating difficulties for safety (including toxicity profiles), governance and transparency. This review assesses the utility of nanomedicines in healthcare, clarifying key concepts in the literature, examining past, present and future nanomedicines and analyzing gaps in current regulations. Advances in nanomedicine offer unique opportunities including programmable and controllable nanoparticles (nanobots) that work cooperatively (nanoswarms), rather than individually, to achieve a targeted, personalized, and intelligent cancer treatment. Swarm behavior can be designed using a systems approach as in silico modelling has now advanced to the point of being a useful tool for selecting nanoparticles that optimize treatment outcomes. We need to understand what the first-in human clinical trial of nanoswarms should/will look like, and anticipate the associated ethical questions that may arise. To aid clinical adoption of nanoswarms in cancer treatment, a harmonized nanomedicine vocabulary is needed alongside a robust, specific and overarching regulatory framework that can guide researchers, regulators and other key stakeholders.