Author(s) :

Trisha Manipatruni.

Volume/Issue :

Abstract :

Despite decades of progress, cancer is still frequently detected only at advanced stages, and conventional treatments such as surgery, chemotherapy, and radiation therapy often lack tissue specificity. These limitations have motivated the development of approaches that unify early detection with targeted treatment in a single system. A nanotheranostic platform is an engineered nanoparticle construct that integrates therapeutic and diagnostic functions within a single system. In preclinical studies conducted both in vitro and in animal models, such platforms have shown early evidence of the capacity to improve lesion visualization, enable image-guided treatment activation, and support treatment-response monitoring. This review breaks down nanotheranostic platforms into three core design dimensions: therapeutic modality (including photothermal therapy (PTT), photodynamic therapy (PDT), chemotherapy, and multimodal systems), diagnostic readout (primarily fluorescence and magnetic resonance imaging (MRI)) and targeting strategy (including passive accumulation via the enhanced permeability and retention (EPR) effect, ligand-mediated active targeting, and organelle localization). By integrating diagnostic and therapeutic components, these platforms are designed to increase tumorassociated delivery and enable image-guided activation, with reported improvements in tumor control in preclinical models. Across cited studies, multimodal nanotheranostic systems often demonstrate improved tumor control relative to single-modality comparators within the same experimental model. However, reductions in systemic toxicity and improvements in patient quality of life remain unverified in clinical settings. To identify the most promising clinically translatable strategies, this review examines critical barriers to translation, including immune clearance, batch-to-batch variability, manufacturing scale-up, regulatory complexity, and long-term biodistribution. The review concludes by identifying design principles associated with stronger translational positioning compared to platforms that remain preclinical.