Recent advances on chitosan/hyaluronic acid-based stimuli-responsive hydrogels and composites for cancer treatment: A comprehensive review

Cancer, as leading cause of death, has a high rate of mortality worldwide. Although there is a wide variety of conventional approaches for the treatment of cancer (such as surgery and chemotherapy), they have considerable drawbacks in terms of practicality, treatment efficiency, and cost-effectiveness. Therefore, there is a fundamental requirement for the development of safe and efficient treatment modalities based on breakthrough technologies to suppress cancer. Chitosan (CS) and hyaluronic acid (HA) polysaccharides, as FDA-approved biomaterials for some biomedical applications, are potential biopolymers for the efficient treatment of cancer. CS and HA have high biocompatibility, bioavailability, biodegradability, and immunomodulatory function which guarantee their safety and non-toxicity. CS-/HA-based hydrogels (HGs)/composites stand out for their potential anticancer function, versatile preparation and modification, ease of administration, controlled/sustained drug release, and active and passive drug internalization into target cells which is crucial for efficient treatment of cancer compared with conventional treatment approaches. These HGs/composites can respond to external (magnetic, ultrasound, light, and thermal) and internal (pH, enzyme, redox, and ROS) stimuli as well which further paves the way to their manipulation, targeted drug delivery, practicality, and efficient treatment. The above-mentioned properties of CS-/HA-based HGs/composites are unique and practical in cancer treatment which can ignore the deficiencies of conventional approaches. The present manuscript comprehensively highlights the advances in the practical application of stimuli-responsive HGs/composites based on CS/HA polysaccharides.