A new generation of smart nanocarriers offers excellent safety, efficiency, and targeted drug delivery for cancer immunotherapy. Conventional cancer treatments, such as radiation and chemotherapy, are often associated with severe systemic toxicity and extensive collateral damage to healthy tissues. In contrast, the enhanced permeability and retention effect and active targeting mechanisms of certain nanocarriers, such as liposomes, dendrimers, polymeric nanoparticles, and lipid-based systems, enable precise drug delivery. Therapeutic agents can be encapsulated within nanoscale delivery systems, protected from early degradation, and released in response to specific signals within the tumor microenvironment, such as changes in pH or enzyme concentrations. Targeting accuracy is further improved through surface modifications, including ligands, antibodies, or aptamers, which facilitate intracellular uptake and mitigate off-target effects. Additionally, the wide variety of nanocarrier structures available—from polymersomes and micelles to nanospheres and nanocapsules—allows customized applications tailored to different cancer types and stages. Current research highlights the potential for immunomodulatory drugs loaded into nanocarriers to enhance antitumor immunity and overcome mechanisms of immunoresistance. This review discusses the classification, processes, and biological applications of smart nanocarriers, with particular emphasis on how they can advance cancer immunotherapy by addressing challenges related to drug loading, targeted delivery, and biocompatibility.

BACKGROUND: Cardiovascular disease is a significant contributor to the disease burden in geriatric patients. Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis. The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome (ACS). METHODS: This was a prospective observational study of 601 older adult patients (age > 60 years) with ACS who underwent percutaneous coronary intervention over two years (2017-2019). The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up. Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters. RESULTS: The mean age of presentation was 77 ± 17 years. The mean neutrophil-lymphocyte ratio (NLR) value was 5.07 ± 4.90 and the mean platelet-lymphocyte ratio (PLR) value was 108.65 ± 85.82. On univariate analysis, total leucocyte count [odds ratio (OR) = 0.85, P = 0.021], hematocrit (OR = 0.91, P = 0.018), NLR (OR = 1.10, P = 0.001) and PLR (OR = 1.05, P = 0.001) were associated with mortality. On receiver operating characteristic curve analysis, NLR predicted mortality with 68.1% and PLR with 65.7% accuracy. On multivariate analysis, NLR (OR = 1.096, 95% CI: 1.006-1.15, P = 0.035) was an independent predictor of 30-day mortality. CONCLUSIONS For the risk classification of all elderly ACS patients, we highly advise using NLR rather than the total white blood cell count.

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