Ultrasound-activated nanomedicines for hepatocellular carcinoma: A new frontier in cancer theranostics

Ultrasound-activated nanomedicine has been identified as an effective, non-invasive modality for cancer theranostics, offering real-time imaging accompanied by localized therapeutic activation. Hepatocellular carcinoma (HCC) remains one of the most prevalent and deadliest cancers globally, typically diagnosed at advanced stages with scarce treatment options. In this comprehensive review, we elaborate on the prime therapeutic modalities, including high-intensity focused ultrasound (HIFU), low-intensity focused ultrasound (LIFU), and sonodynamic therapy (SDT), underlining their potential in triggering site-specific drug release, improving tumor penetration, and increasing therapeutic efficacy. Active mechanisms for tumor targeting, reinforced by ultrasound, and design requirements for effectively engineering ultrasound-responsive nanosystems for managing HCC receive special consideration. Ultrasound-activated nanomedicine platforms are reviewed for their diagnostic and therapeutic integration into HCC theranostics, enabling real-time monitoring and personalized treatment. We also delve deeper into preclinical advancements and clinical trial outcomes, emphasizing the translational potential of these platforms. The review concludes by exploring the future of cancer therapy using ultrasound, including precision-guided interventions and synergistic combinations with immunotherapy and gene editing technologies. Inclusively, ultrasound-activated nanomedicines represent a revolutionary frontier for personalized HCC theranostics.