Multimodal nanomedicine for precision colorectal cancer management: integrated diagnosis, targeted therapy, and personalized theranostics

Colorectal cancer (CRC) imposes a substantial health burden because of its high incidence and mortality. Despite advances in surgical procedures, chemotherapy, radiotherapy, targeted therapy, and immunotherapy, the overall efficacy is still unsatisfactory, especially for advanced CRC. This disease burden reflects delayed detection, dose-limiting systemic toxicity, and intrinsic or acquired drug resistance. Therefore, more effective diagnostic and therapeutic strategies are urgently needed to improve patient survival and quality of life. By exploiting the distinctive physicochemical properties of nanomaterials, nanomedicine offers promising opportunities to improve CRC diagnosis and treatment. This review systematically summarizes recent advances in nanomaterial-based strategies for the integrated diagnosis and treatment of CRC. In the diagnostic setting, we focus on nanomaterial-enhanced magnetic resonance imaging (MRI), positron emission tomography (PET), photoacoustic imaging (PAI), and highly sensitive nanosensors for biomarker detection, which may improve diagnostic sensitivity, specificity, and early disease detection. In the therapeutic setting, we examine five major strategies through which nanomaterials address key therapeutic and immune barriers: targeted delivery, enhancement of chemotherapy, reversal of drug resistance, delivery of nucleic acids and gene-editing systems, and remodeling of the tumor microenvironment to promote the conversion of immunologically “cold” tumors into treatment-responsive “hot” tumors. We also discuss nanomaterial-enabled multimodal approaches, including photothermal therapy, photodynamic therapy, and their integration with radiotherapy and chemotherapy. Finally, we highlight emerging directions, including multifunctional nanomaterial engineering, clinical translation, and the development of personalized precision medicine. The integration of artificial intelligence with interdisciplinary research may accelerate the rational design and clinical development of integrated theranostic platforms, offering new opportunities for precision CRC management.