Chemotherapy predominates in clinical treatment of
prostate cancer (PCa), while irreversible resistance to chemotherapeutics and severe side effects hinder the therapeutic efficacy, especially in
castration-resistant PCa (CRPC). Herein, a
bombesin (BBN)-decorated two-in-one
prodrug (T-NO/E2-PMs) incorporating a polymeric
nitric oxide (NO) donor and
acetal-linked 17β-estradiol (E2) in one backbone is developed, aiming to inhibit
androgen receptor (AR) expression, reprogram the tumor microenvironment of CRPC, and enhance
estradiol-mediated hypoxic CRPC
therapy. Following efficient internalization mediated by BBN, T-NO/E2-PMs releases
estradiol and NO in response to the unique intracellular environments. Both in vitro and in vivo studies demonstrate that the T-NO/E2-PMs nano-
prodrug along with NO release potently downregulates AR levels to reverse CRPC and further enhances the chemo-sensitization of
estradiol to PCa PC-3 cell apoptosis and the inhibition of
metastasis. Collectively, this two-in-one nano-
prodrug strategy offers a promising platform for construction of advanced nanomedicine to boost the therapeutic efficacy.