Echoes of innovation: nanomaterials-based sonodynamic therapy in the war on cancer

Sonodynamic therapy (SDT) is an innovative cancer treatment that uses ultrasound to activate sonosensitizers at tumor sites, producing toxic reactive oxygen species (ROS) to trigger apoptosis or necrosis of tumor cells. The efficacy of SDT heavily relies on the ability of sonosensitizers to efficiently convert ultrasound energy into chemical energy. SDT has notable benefits such as deep tissue penetration, high accuracy, and low toxicity, making it promising in cancer therapy. Traditional sonosensitizers are limited in clinical use due to issues such as poor solubility, instability in blood circulation, and inadequate tumor targeting. In recent years, nanomaterial-based sonosensitizers have overcome these limitations, showcasing unique advantages and significantly enhancing SDT efficacy. This paper extensively reviews SDT mechanisms such as ultrasound-induced cavitation, ROS production, and tumor microenvironment modulation, with an emphasis on the progress of polymeric, liposomal, and nanomaterials like metal-, silicon-, and carbon-based sonosensitizers. Finally, the prospects of SDT in cancer therapy are discussed, highlighting the need for further clarification of its mechanisms and the development of novel, efficient nanomaterial-based sonosensitizers to realize its clinical potential.