A Comprehensive Review of Vitamin C for Cancer Therapy: Anti-Tumor Mechanisms and Nano-Formulation Strategies

Pinxu Ge,1 Xiaomei Tao,1 Jinxiu Qu,1 Jia He,1 Chenqi Xing,2 Shiwan Wang,1 Yuan Zhao,1 Shijie Yu,1 Jiqiang Xu,1 Liang Wang,1 Yuru Li,1 Xin Wang,1 Benqiang Rao1 1Department of Peritoneal Tumor and Malignant Bowel Obstruction Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China; 2Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, 510060, People’s Republic of ChinaCorrespondence: Benqiang Rao, Email raobenqiang@bjsjth.cn Xin Wang, Email winsun2011@163.comAbstract: The rapid advancements in nanotechnology have provided unprecedented opportunities for the clinical translation of vitamin C (VC) in cancer therapy. Although pharmacological doses of VC exhibit potent anti-tumor activities via multiple mechanisms—including selective pro-oxidative stress induction, metabolic inhibition, epigenetic modulation, and immune function enhancement—the clinical application of VC remains significantly hindered by its inherent instability, short biological half-life, and lack of tumor-specific targeting. Recent progress in the design and synthesis of VC and its derivatives combined with advanced nanocarriers has enabled precise delivery and efficient release of VC at tumor sites. In this review, we systematically summarize recent advances in nano-formulation strategies of VC, with a detailed discussion of lipid-based nanocarriers including liposomes, solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), polymeric nanoparticles, as well as metal-based nanozyme delivery systems primarily composed of iron, copper, and manganese. These nano-systems not only significantly enhance the stability and circulation half-life of VC but also exploit tumor microenvironment-specific stimuli, such as pH, hydrogen peroxide (H2O2), and glutathione (GSH), to achieve responsive and precise drug release in cancer tissues. Notably, metal-based nanomaterials in combination with VC synergistically catalyze the Fenton reaction, markedly boosting reactive oxygen species (ROS) generation and demonstrating remarkable anti-tumor efficacy. Moreover, nanotechnology platforms have facilitated effective combination therapies involving VC with chemotherapeutic agents, photothermal catalysts, and immune agonists. Finally, this article highlights key challenges in the clinical translation of nano-formulated VC, including safety evaluation, scale-up production, and prediction of therapeutic efficacy. Future research directions in nano-drug design and exploration of synergistic mechanisms are proposed, providing theoretical guidance and practical insights for precise cancer therapy using VC-based nanomedicine.Keywords: vitamin C, ascorbic acid, cancer therapy, nanoparticle, drug delivery, Fenton reaction