Advances and challenges of sonodynamic nanomedicines for deep seated tumor therapy

Sonodynamic therapy (SDT) has become a promising, noninvasive treatment modality with deep tissue penetration and precise controllability, offering a new approach for cancer treatment. Nanotechnology improves stability, targeting ability, and therapeutic efficiency of sonosensitizers in deep-seated tumors. This review discusses recent advances in sonodynamic nanomedicines for treating pancreatic, hepatic, and colorectal cancers, focusing on design strategies and mechanisms of metal-based, nonmetal-based, and hybrid nanosystems. Current challenges such as limited reactive oxygen species (ROS) generation, insufficient tumor targeting, hypoxia tolerance, and biosafety concerns are discussed. Future perspectives on multimodal combination therapy, stimuli-responsive nanocarriers, and clinical translation are also highlighted. This review aims to provide insights into the rational design and clinical development of SDT-based nanomedicines for deep-seated tumors.