Intracellular logic computing with DNA tetrahedron processors enables precision cancer theranostics.

The integration of molecular computation with nanomedicine holds transformative potential for precision cancer theranostics. However, achieving an intelligent, multi-input decision-making process within living cells remains a formidable challenge because of the complexity of intracellular signaling networks. Here, we present a set of DNA tetrahedron logic processors that enable smart intracellular computing through a programmable three-input architecture capable of executing seven Boolean operations-OR, AND, NOR, NAND, XOR, majority (MAJ), and OR-AND-in response to endogenous miRNA signals. Building upon the cell-internalizable tetrahedral framework nucleic acid, this processor functions as an autonomous sense-and-treat module: it decodes combinatorial biomarker states and conditionally releases therapeutic siRNA only when a predefined logical condition is met. As a proof of concept, in precision oncology, we engineered a MAJ-gated nanoplatform (siR@MAJ) that selectively silences survivin in MCF-7 breast cancer cells that exhibit a specific tri-miRNA signature while sparing other cell types. This approach has achieved potent tumor suppression both in vitro and in vivo with high specificity and minimal off-target effects. By integrating multi-target detection into a single logic circuit, this processor significantly improves the discriminative capability within complex biological environments. Our work establishes a foundational platform for intelligent intracellular diagnostics and therapy, paving the way toward adaptive, logic-driven nanomedicine.