Tailoring Advanced Metal-Based Nanomedicines for Adaptable Nanodynamic Disease Therapies and Theranostics.

Advanced metal-based nanomaterials (MBNs) represent a dynamic frontier in nanomedicine, offering a versatile platform for next-generation diagnostics and therapeutics. Their tunable structures and catalytic, optical, and magnetic properties enable diverse nanodynamic therapies (NDTs), including photodynamic, chemodynamic, sonodynamic, thermodynamic, piezoelectric, radiodynamic, and magnetodynamic modalities. In addition to the well-established tumor ablation, MBNs also feature potent antimicrobial and antiviral activity, functioning via reactive oxygen species generation, immune modulation, and biofilm disruption. Recent developments in metal-organic frameworks, metal-phenolic networks, and 2D metal nanosheets have expanded the toolkit for precision drug delivery, imaging-guided therapy, and bioresponsive release strategies. This comprehensive review highlights the structural design principles, therapeutic mechanisms, and versatile biomedical applications of emerging MBN platforms, emphasizing synergistic treatment strategies and their role in overcoming hypoxia, multidrug resistance, and immunosuppression. Despite their promise, clinical translation remains hindered by unresolved issues in long-term biosafety, biodegradation, and scalable manufacturing. Future efforts are expected to focus on tailoring intelligent nanostructures with optimized pharmacokinetics, integrating multimodal imaging with real-time therapeutic feedback, and ensuring regulatory compliance. Continued innovation at the interface of materials science, biology, and medicine will be essential for transforming MBN-based systems into clinically viable tools for oncology, infectious disease control, and personalized medicine.