Chitosan-based therapeutic approaches for gastrointestinal malignancies: A review of novel drug delivery platforms and theragnostic systems

Gastrointestinal (GI) malignancies, including gastric, colorectal, pancreatic, esophageal, and hepatocellular carcinomas, pose a substantial global health risk due to their high morbidity and death rates. Traditional interventions, including surgery, chemotherapy, and radiation therapy, have limited efficacy and frequently lead to adverse effects, thereby highlighting the need for novel therapeutic approaches. Chitosan, a biocompatible and biodegradable polysaccharide derived from chitin, has emerged as a promising agent in cancer therapy due to its unique properties, including mucoadhesion and pH responsiveness. Chitosan-based nanoparticles (NPs) designed for targeted drug delivery to cancer cells can facilitate prolonged drug release, overcome multidrug resistance, enhance therapeutic efficacy, and minimize systemic toxicity. Chitosan compounds have been shown to inhibit the growth and metastasis of gastric tumors while augmenting immune responses. Furthermore, chitosan-based nanocarriers can enhance the bioavailability of chemotherapeutic drugs and promote apoptosis in colorectal cancer cells, and have been used to boost targeted drug delivery and improve diagnostic sensitivity in pancreatic and esophageal malignancies. Likewise, chitosan-based systems have demonstrated therapeutic potential in hepatocellular carcinoma by enhancing drug accumulation in tumor tissues and promoting apoptosis. In this review, we have summarized the latest research on the application of chitosan and its derivatives in the treatment of gastrointestinal malignancies, with particular emphasis on the different delivery platforms like NPs, micelles, and hydrogels. In addition, the potential for developing advanced chitosan-based theragnostic systems for personalized therapy has also been highlighted. • This review highlights the potential of chitosan in advancing GI cancer diagnosis and therapy. • Theranostic chitosan systems enable safer, personalized treatment for gastric and colorectal tumors. • Chitosan-based nanocarriers enhance targeted therapy in gastrointestinal malignancies. • Mucoadhesive, pH-responsive chitosan improves drug delivery efficiency and reduces toxicity. • Chitosan nanoparticles stimulate immune response and inhibit tumor growth in GI malignancies.