Application of multivalent aptamers in tumor diagnosis, analysis and therapy (Review)

Cancer remains one of the leading causes of mortality worldwide, making early diagnosis and precise treatment crucial for enhancing patient survival rates. Previously, nucleic acid aptamers have emerged as promising tools in tumor diagnosis, analysis and therapy, owing to their high specificity, cost-effectiveness and ease of modification. Unlike monovalent aptamers, multivalent aptamers markedly improve target affinity and specificity through multipoint binding, demonstrating superior efficacy in the detection, capture and treatment of tumor cells. The present study reviews the construction methods of multivalent aptamers, their applications in tumor diagnosis and therapy and their challenges and prospects. Constructed through nucleic acid nanostructure self-assembly, bio-coupling, nanomaterial loading and chemical cross-linking, multivalent aptamers can effectively detect circulating tumor cells, enabling the non-invasive release of tumor cells. They serve as alternatives to bispecific antibodies in tumor immunotherapy. Despite challenges in specificity, in vivo delivery efficiency and large-scale production in the tumor microenvironment, multivalent aptamers hold promise for future research in dynamic response technology, artificial intelligence-driven development and clinical application. The present systematic review summarizes advancements in multivalent aptamers in oncology over the past decade and their potential application in precision medicine.