Application Advances of Gold Nanoparticles in Cancer Theranostics: From Physicochemical Mechanisms to Multifunctional Nanoplatforms

The high morbidity and mortality of cancer pose a severe challenge to human health. Traditional diagnostic and therapeutic strategies still exhibit obvious limitations in early diagnostic sensitivity, therapeutic precision, and real-time monitoring of treatment efficacy. The development of nanotechnology has provided novel solutions for precision cancer theranostics. Among nanomaterials, gold nanoparticles (AuNPs) have become a research hotspot in tumor nanomedicine due to their tunable size and morphology, excellent localized surface plasmon resonance (LSPR) effect, and favorable biocompatibility. However, despite encouraging preclinical outcomes, several challenges hinder their clinical translation, including an incomplete understanding of long-term toxicity, complex in vivo biological interactions, the lack of standardized evaluation protocols, and regulatory uncertainties and manufacturing reproducibility issues. This paper systematically reviews the physicochemical and biological mechanisms of AuNPs in cancer theranostics, and summarizes the latest research advances of AuNPs in cancer detection and diagnosis (including biomarker detection and multimodal imaging) as well as in therapeutic fields, covering photothermal therapy (PTT), photodynamic therapy (PDT), radiosensitization, targeted drug and nucleic acid delivery, and immunotherapy-assisted strategies. Furthermore, we discuss the development of intelligent and stimuli-responsive theranostic nanoplatforms based on AuNPs, and outline their future prospects in precision medicine and personalized cancer therapy, with particular emphasis on the requirements for clinical translation, including safety evaluation, large-scale production, and regulatory approval pathways.