Enzyme-based nanomedicine for tumor microenvironment modulation in cancer therapy

The tumor microenvironment (TME) is a major driver of therapeutic resistance, shaped by abnormal vasculature, metabolic rewiring, redox imbalance, dense extracellular matrix deposition, and immunosuppressive signaling. These biochemical and biophysical barriers restrict drug delivery, promote tumor progression, and limit the efficacy of cancer therapy. Enzyme-based nanomedicine offers a catalytic strategy to modulate TME features through localized enzymatic reactions. This Review discusses two major platforms: enzyme-loaded nanoparticles, which protect and deliver natural enzymes, and enzyme-mimicking nanomaterials, or nanozymes, in which the nanomaterial itself provides catalytic activity. We focus on how material design regulates enzyme stability, catalytic accessibility, tumor delivery, and biological activity, with particular emphasis on redox regulation and metabolic modulation, where mechanistic and preclinical evidence is most developed. We also discuss extracellular matrix remodeling and immune modulation as important but more context-dependent applications that may improve drug penetration or support immunotherapy in tumors. Finally, we examine key translational challenges, including catalytic specificity, substrate heterogeneity, delivery barriers, immune recognition, manufacturing complexity, and long-term safety. Aligning catalytic function with tumor biology may enable enzyme-based nanomedicine to improve the performance of current cancer therapies.