Recent Advances in Near-Infrared Probes for Monitoring Drug Treatment Responses: Toward Efficacy Evaluation and High-Throughput Screening.

Accurate drug efficacy evaluation and efficient potential drug screening are cornerstones of translational pharmacology, as they can directly underpin the optimization of therapeutic regimens, acceleration of drug development pipelines, and improvement of patient clinical outcomes. However, conventional analytical approaches for these tasks often suffer from inherent limitations, including invasiveness, low sensitivity to subtle molecular changes, inability to achieve real-time in vivo monitoring of therapeutic dynamics, and poor compatibility with physiologically relevant disease models. In response to these unmet needs, near-infrared (NIR) fluorescent probes have emerged as transformative tools, leveraging a suite of unique advantages, such as noninvasiveness, ultrahigh sensitivity, excellent target specificity, operational simplicity, deep tissue penetration, and cost-effectiveness, to enable precise, spatiotemporal tracking of drug actions in both preclinical and early clinical settings. This review provides a comprehensive, up-to-date overview of recent advances in the rational design and translational applications of NIR probes for drug efficacy assessment and high-throughput screening (HTS). Specifically, NIR probes can systematically detect drug-induced biochemical and microenvironmental alterations and, when are integrated into automated HTS platforms, significantly enhancing screening sensitivity, throughput, and physiological relevance. Finally, we delineate key challenges impeding the widespread clinical translation of NIR probe technology and outline future research directions. Progress in therapeutic areas holds profound potential to refine personalized drug treatment strategies, accelerate late-stage clinical trial validation, and drive paradigm-shifting innovations across the global pharmaceutical industry.