In Situ Oxygenic Nanopods Targeting Tumor Adaption to Hypoxia Potentiate Image-Guided Photothermal Therapy

Tumor adaption to hypoxic stress not only plays a crucial role in tumor malignancy but also can protect cancer cells from therapeutic interventions. Hence, therapeutic strategies attenuating tumor hypoxia in conjunction with conventional therapies may be an ideal approach. Here, we report the application of in situ oxygenic carbon nano-onion (CNO)/manganese oxide nanopods (iOCOMs) as novel theranostic photothermal transducers to neutralize the oncogenic influence of the hypoxic tumor microenvironment (TME). The developed onion-ring-shaped carbon nanoparticles or carbon nano-onions (CNOs) and iOCOM nanopods (CNO embedded in MnO₂ nanosheets) were biologically stable and nontoxic and showed photothermal activity under near-infrared laser irradiation (808 nm). In addition, iOCOM assisted in the dismutation of hydrogen peroxide (H₂O₂), a potentially toxic reactive oxygen species that is secreted excessively by cancer cells in the hypoxic TME, resulting in in situ oxygenation and repolarization of the hypoxic TME to normoxia. The manganese ions released from iOCOM during the catalysis of H₂O₂ assisted in TME-responsive T₁ magnetic resonance imaging (MRI). The in situ oxygenation by iOCOM in the hypoxic TME downregulated the secretion of hypoxia-inducible factor 1-α, which subsequently interfered with the cancer cell proliferation, favored tumor angiogenesis, and most importantly prevented metastatic epithelial-to-mesenchymal transition of tumor cells. Collectively, this work presents a new paradigm for antitumor strategies by targeting the tumor adaption to hypoxia in combination with photothermal therapy.