Reimagining drug nanocarriers: clinical realities and smarter strategies for targeted drug delivery

Recent advances in nanomedicine have significantly improved the delivery of small molecule therapies and biologics for cancer treatment, gene therapy, and vaccines, leading to better patient outcomes and improved standard of care. Yet, despite the promise of targeted drug delivery, clinical trials of targeted nanoparticle-based systems have frequently underperformed. In this opinion piece, we explore the persistent obstacles facing nanomedicine, analyse the shortcomings of targeted strategies, and propose a path forward. We argue that progress will require a re-examination of nanoparticle pharmacokinetics, optimisation of dosing regimens, and solutions to antigen depletion. These steps are critical for realising the full potential of nanomedicine.