Metallic nanoparticles in precision medicine for gastrointestinal cancers: Diagnostic and therapeutic advances

Gastrointestinal cancers (GI) rank among the most common and lethal tumors. The traditional therapies face limitations in the early diagnosis, accurate targeting, and treatment effectiveness. Metallic nanoparticles (MNPs) such as Au, Ag, and iron oxide present various promising opportunities owing to their exceptional physicochemical properties including high surface area-to-volume ratios, tunable surface chemistry, and biological interactions. Therefore, understanding the function and application of MNPs in the treatment of specific cancers and advancing cancer diagnosis can provide valuable clinical insights. This review assesses the capabilities of MNPs in GI cancers, focusing on the drug delivery, imaging, photothermal therapy (PTT), and the enhancement of radiotherapy. The primary findings encompass using gold nanoparticles (AuNPs) for the targeted drug delivery, photothermal-induced tumor ablation, and radiosensitization in colorectal, pancreatic, and gastric cancers. AgNPs can not only enhance chemotherapy and photodynamic therapy (PDT) but also induce apoptosis. Iron oxide nanoparticles (IONPs) aid in magnetic drug targeting, enhance magnetic resonance imaging (MRI) contrast, and enable combined chemo-photothermal therapy. Metal-organic frameworks (MOFs) facilitate drug delivery, multimodal imaging, and combination treatments, including photodynamic and immunotherapy, for colorectal and pancreatic cancers. The review emphasizes the recent advancements in MNP-based theranostic platforms, showcasing their ability to enhance the early detection, overcome drug resistance, and boost the therapeutic index. The obstacles such as off-target effects, scalability and chronic toxicity are addressed, along with methods for enhancing MNP design and its clinical use. This review emphasizes the transformative possibilities of MNPs in tackling the worldwide challenge of GI cancers.