**4. Approved application and indication of nanomedicine**

### **4.1 Cancer nanoparticle medicines**

Most pharmaceutical industries are focusing on developing new products for cancer as it is the first cause of death in 50% of the countries. Nanomedicine products have a good share in this market with many approved products to treat several types of cancer at various stages. Abraxane® is a famous albumin-particle bound paclitaxel nanomedicine loaded for advanced non-small cell lung cancer, metastatic breast cancer, and metastatic pancreatic cancer. Doxil®, the first approved nanomedicine by the FDA in 1995, is a PEGylated liposome loaded with doxorubicin for ovarian cancer, HIV-associated Kaposi's sarcoma, and multiple myeloma. Marqibo® is a liposomal vincristine for Philadelphia chromosome-negative acute lymphoblastic leukemia. Hensify® is the recently approved nanomedicine for cancer in 2019 by the FDA. It is the hafnium oxide nanoparticles stimulated with external radiation to enhance tumor cell death via electron production for locally advanced squamous cell carcinoma. Most of the approved nanomedicines are non-PEGylated except Doxil and Onivyde, which is interesting as most reports have proven the importance of nanomedicine coating with PEG. Furthermore, all nanomedicine products do not have active target moiety. So, all of these products follow passive targeting approach without even stealth characteristics.

#### **4.2 Iron-replacement nanoparticle therapies**

Iron-replacement therapy to treat anemia is surprisingly another area for nanomedicine due to the significance of nanoscale iron-oxide colloid system in improving iron absorption to the body. The main advantage of iron-oxide nanomedicine is replacing the injection of free iron with its associated toxicity. Most of these nanosystems are coated with either polysaccharide or polymer to reduce iron toxicity. CosmoFer® is the first approved iron dextran colloid by the FDA in 1996. Injectafer® is the most recent one in 2013 by the FDA, which is iron carboxymaltose colloid.

#### **4.3 Nanoparticle/microparticle imaging agents**

Another area for nanomedicine, especially the inorganic ones, is diagnostics, mainly imaging agents. Iron-oxide nanomedicines are also approved as contrasting agents for magnetic resonance imaging, which is used to generate contrasted images for different types of cancers. The magnetic property and small particle size allow the distribution of iron-oxide nanomedicine in tumor tissue, which provide a precise imaging of cancer borders. Additionally, perflutren is also used as ultrasound contrast agent in either lipid- or albumin-based nanomedicines. Phospholipidstabilized microbubble is another form of nanomedicine as ultrasound contrast agent, which is approved in 2001 by the EMA. Its main mechanism is encapsulating air bubbles, which act as reflectors for ultrasound.

### **4.4 Nanoparticles for vaccines, anesthetics, fungal treatments, and macular degeneration**

Several clinical applications have been studied using nanomedicine. Diprivan® is the first FDA-approved nanomedicine in 1989 for anesthesia. Another field for nanomachine is vaccination with two products, which are Epaxal® for hepatitis A and Inflexal V® for influenza. Both vaccines are liposome-based nanomedicine due

**9**

**Author details**

**5. Conclusion**

especially cancer.

**Conflict of interest**

Islam Ahmed Hamed Khalil1,2\*, Islam A. Arida2

The authors declare no conflict of interest.

Science and Technology, Giza, Egypt

provided the original work is properly cited.

1 Department of Pharmaceutics, College of Pharmacy and Drug Manufacturing,

2 Nanoscience Department, University for Science and Technology, Zewail City of

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

Misr University of Science and Technology (MUST), Giza, Egypt

\*Address all correspondence to: islam.khalil@must.edu.eg

and Mohamed Ahmed2

*Introductory Chapter: Overview on Nanomedicine Market*

to the similarity of liposome structure to cell structure. Another famous liposome product is AmBisome®, which is a liposome loaded with amphotericin B for treating systemic fungal infections with reduced toxicity. Abelcet® is another approved lipid-based nanomedicine loaded with amphotericin B. Finally, Visudyne® is a liposomal verteporfin for treatment of subfoveal choroidal neovascularization from

Nanomedicines are currently in the middle of the road with great potentials but require many development considerations regarding assessment of physicochemical properties, pharmacokinetic properties, and pharmacodynamic applications. Based on the recent trends with 47 products in clinical trial phases, it is expected that within the next few years, more products will be available for several applications,

age-related macular degeneration, pathologic, or ocular histoplasmosis.

*DOI: http://dx.doi.org/10.5772/intechopen.91890*

*Introductory Chapter: Overview on Nanomedicine Market DOI: http://dx.doi.org/10.5772/intechopen.91890*

to the similarity of liposome structure to cell structure. Another famous liposome product is AmBisome®, which is a liposome loaded with amphotericin B for treating systemic fungal infections with reduced toxicity. Abelcet® is another approved lipid-based nanomedicine loaded with amphotericin B. Finally, Visudyne® is a liposomal verteporfin for treatment of subfoveal choroidal neovascularization from age-related macular degeneration, pathologic, or ocular histoplasmosis.
