Implantable Microsystems for Personalised Anti-Cancer Therapy

癌症是一种众所周知且令人畏惧的致命疾病，仅在欧洲每年就有100多万人死于癌症。目前，放射治疗和化疗是主要的治疗形式。根据临床医生的经验以及治疗设备和工作人员的可用性，定期(通常是每周)将这些设备和人员送到由CT或MRI扫描结果确定的地点。化疗通常是以注射或口服的形式进行的，因此会影响与肿瘤无关的身体区域。IMPACT(*)将开发微小的硅芯片，放置在患者体内靠近肿瘤的地方，以非常精确地测量癌症在空间和时间上的“活性”。这些芯片将测量简单的数量，如酸度、温度和氧气浓度，以及更复杂和困难的数量，如指示肿瘤状态和其中癌细胞死亡的特定蛋白质的水平。他们将专注于测量肿瘤目前对放射和化疗的易感性，从而确定治疗的地点和时间。有了这些知识，放射治疗可以在正确的地点和正确的时间对肿瘤造成最大的损害。同样，通过进一步开发小型化的芯片上药物输送能力，以保护其传感器免受“生物污染”，IMPACT为能够在正确的地点和正确的时间给药的系统铺平了道路。因此，IMPACT的工作旨在满足癌症专家一直强调的临床优先事项。然而，对化学家和(硅)工程师来说，科学和技术方面的挑战。必须开发传感器，其中许多都是全新的，可以进行正确的测量。然后，这些传感器必须放置在硅上，具有植入的医疗诊断和治疗系统所需的所有支持电路、无线通信和安全功能。因此，IMPACT由一个由工程师、化学家以及医学和兽医临床医生组成的团队领导。它还包括社会科学家，因为它的结果有可能彻底改变癌症的治疗方式。Impact的含义是，治疗的时间和地点将高度因人而异。仔细考虑这种技术的道德、风险和管理从一开始就至关重要，因为Impact的成功将挑战患者的看法以及治疗的组织和安排，还将挽救许多人的生命。(*)用于个性化抗癌治疗的可植入微系统。

Cancer is a well-known and much-feared killer disease, accounting for over a million deaths each year in Europe alone. Currently, radiotherapy and chemotherapy are the primary forms of treatment. They are delivered on a regular (often weekly) schedule based on the experience of clinicians and the availability of equipment and staff for treatment, to locations that are determined by the results of CT or MRI scanning. Chemotherapy is generally administered systemically, either as an injection or orally and thus affects regions of the body that have nothing to do with the tumour.IMPACT(*) will develop tiny silicon chips to be placed inside the patient's body, close to a tumour to measure the cancer's "activity" very precisely in both space and time. The chips will measure simple quantities such as acidity, temperature and oxygen concentration and also more complex and difficult quantities such as the levels of particular proteins that indicate the status of the tumour and the death of cancer cells within it. They will concentrate on measuring the tumour's current vulnerability to radio- and chemo-therapy, and thus where and when that therapy should be targeted. With this knowledge, radiotherapy can be delivered to the right place and the right time to do maximum damage to a tumour. Similarly, by further developing a miniaturised, on-chip drug-delivery capability to protect its sensors from "biofouling", IMPACT paves the way for systems that can also administer chemotherapy to the right place and at the right time.The work in IMPACT is therefore designed to meet a clinical priority that has been stressed by cancer specialists. The scientific and technical challenges are, however to Chemists and (silicon) Engineers. Sensors must be developed, many of them entirely novel, which make the correct measurements. These sensors must then be placed on silicon, with all the support circuits, wireless communications and safety features that this implanted medical diagnostic and therapeutic system needs.IMPACT is therefore led by a team of engineers, chemists and both medical and veterinary clinicians. It also includes social scientists, as its results have the potential to revolutionise the way in which cancers are treated. IMPACT's implication is that the timing and location of treatment will be highly patient-specific. Careful consideration of the ethics, risks and regulation of such technology is vital from its inception as IMPACT's success will challenge both patients' perceptions and the organisation and scheduling of therapy.It will also save many lives.(*) Implantable Microsystems for Personalised Anti-Cancer Therapy.