Emerging Piezoelectric Sonosensitizer for ROS-Driven Sonodynamic Cancer Therapy

As a non-invasive modality, sonodynamic therapy (SDT) offers several advantages in cancer treatment, including deep tissue penetration and precise spatiotemporal control, resulting from the interplay between low-intensity ultrasound and sonosensitizers. Piezoelectric materials, known for their remarkable capacity of interconversion of mechanical and electrical energy, have garnered considerable attention in biomedical applications, which can serve as pivotal sonosensitizers in SDT. These materials can generate internal electric fields via ultrasound-induced mechanical deformation, which modulates the alteration of charge carriers, thereby initiating surface redox reactions to generate reactive oxygen species (ROS) and realizing the therapeutic efficacy of SDT. This review provides an in-depth exploration of piezoelectric materials utilized in SDT, with a particular emphasis on recent innovations, elucidation of underlying mechanisms, and optimization strategies for advanced biomedical piezoelectric materials. Furthermore, the incorporation of piezoelectric sonosensitizers with immunotherapy, photodynamic, chemodynamic, and chemotherapy is explored, emphasizing their potential to enhance cancer therapy outcomes. By examining the basic principles of the piezoelectric effect and its contributions to SDT, this review sheds light on the promising applications of piezoelectric materials in oncology. It also highlights future directions for improving these materials and expanding their clinical utility in tumor sonodynamic therapy.