Protein nanoparticles: a promising frontier in reducing lung complications from chemotherapy in pediatric oncology

Protein nanoparticles (NPs) offer an innovative solution for chemotherapy-induced lung complications in pediatric oncology. This narrative review examines how these biocompatible carriers mitigate pulmonary toxicity through targeted drug delivery and controlled release mechanisms. Different protein sources-albumin, silk fibroin, gelatin, casein, whey, and soya-offer different advantages, with albumin having superior biocompatibility and clinical precedent, while plant proteins offer cost-effective alternatives. Age-specific optimization is critical, with tailored nanoparticle sizes for neonates (50-100 nm), children (100-300 nm), and adolescents (200-500 nm), taking into account differences in lung development. Controlled release kinetics maintain therapeutic drug concentrations while avoiding toxic peaks, significantly reducing inflammatory markers in preclinical models. Despite the promising results, there are still challenges in regulatory approval, manufacturing scalability, and ensuring global availability. The regulatory pathway has been partly taken by albumin-bound paclitaxel (Abraxane), while GRAS (generally recognized as safe) compliant production methods offer scalable solutions. Our strategic roadmap predicts that by 2030, advances in the development of formulations with artificial intelligence and personalized NPs therapies could reduce severe pulmonary complications by 50%, addressing a key research gap in age-specific, lung-protective drug delivery systems for pediatric oncology. This approach represents significant progress toward safer delivery of chemotherapy in vulnerable pediatric populations.