Urinary cancers present a severe clinical challenge due to high recurrence rates. Standard intravesical therapies suffer from limited efficacy because of the urinary tract’s robust physiological defenses, namely, the dynamic washout effect during voiding and highly restrictive urothelial barriers, such as the anti-adhesive glycosaminoglycan layer and intercellular tight junctions. This review aims to explore how biomimetic engineering can overcome these obstacles by transitioning drug delivery from passive carriers to active, nature-inspired systems. We conducted a comprehensive review of the recent literature focusing on biomimetic strategies for intravesical drug delivery and urinary cancer theranostics. The analyzed approaches are categorized into chemical biomimicry (such as adhesion and camouflage) and structural/functional biomimicry (including adaptive devices and microrobots). Biomimetic strategies significantly enhance targeted drug retention and tissue penetration. Chemical biomimicry, utilizing mussel-inspired catechol chemistry and cell membrane camouflage, effectively bypasses the urothelial anti-adhesive defenses and reduces the immune clearance. Structural and functional biomimicry, such as naturally derived carriers and actively propelled magnetic or biohybrid microrobots, enables the precise spatial localization and controlled payload release in dynamic fluid environments. Furthermore, lab-on-a-chip technologies and patient-derived organoids (PDOs) offer scalable platforms for screening cargo-specific efficacies and tailoring treatments, providing a crucial bridge to personalized precision medicine. Integrating nature-inspired designs with advanced nanotechnologies provides a highly promising pathway with which to overcome the mechanical and biological barriers of the urinary tract. These biomimetic innovations hold the potential to shift the therapeutic paradigm for urinary oncology, paving the way for more efficient, targeted, and personalized precision medicine.
Zhong et al. (Thu,) studied this question.