Abstract Solid tumors pose a spatial “delivery-at-depth” bottleneck: therapeutics that reach tumors often remain sequestered near vessels and fail to distribute uniformly into tumor cores. This limitation arises from heterogeneous perfusion, elevated interstitial fluid pressure, and dense extracellular matrix, which together restrict convection–diffusion balance and amplify binding-site barriers. We organize transformable and bioinspired nanomedicines using a barrier-centric lens and summarize five strategy families to deepen and homogenize intratumoral transport: (i) stimuli-responsive size/charge switching, (ii) microenvironment remodeling to restore perfusion and decompress stroma, (iii) ligand-guided transcytosis and CendR pathway engagement, (iv) cell-based and biomimetic vectors leveraging homing and immune evasion, and (v) multistage designs that sequence priming, switching, and payload activation. We compare representative systems by trigger specificity, activation timing, affinity tuning, and corona susceptibility, and highlight recurring failure modes including stimulus heterogeneity, premature/off-target activation, and escalating chemistry–manufacturing–controls burdens with added components. We conclude with translational priorities: couple barrier priming with a single well-characterized switching event, favor moderated or activatable affinity to avoid perivascular trapping, and validate spatial gains using standardized intratumoral distribution metrics linked to therapeutic endpoints. Graphical Abstract
Sheng et al. (Fri,) studied this question.