Applications of carbon-based materials in photothermal therapy for drug-resistant tumors: a review of research from synergistic therapy to theranostics.

Multidrug resistance severely limits the therapeutic efficacy of cancer treatment, and carbon-based material-mediated photothermal therapy (PTT) provides a promising strategy for overcoming tumor drug resistance. This review focuses on graphene oxide, carbon nanotubes, carbon dots, and other carbon-based platforms, and summarizes their material features, biosafety profiles, synergistic therapeutic applications, and theranostic potential in drug-resistant tumors. Current evidence indicates that carbon-based PTT platforms can enhance drug delivery, promote light-responsive release, improve cellular uptake, weaken drug efflux, and regulate ROS-, ATP-, and heat stress-related resistance processes, thereby improving the efficacy of chemo-photothermal and photothermal-photodynamic synergistic therapy. In addition, imaging localization, therapeutic monitoring, and feedback regulation further expand their potential in theranostic applications. However, long-term safety, in vivo clearance, batch-to-batch reproducibility, scalable manufacturing, precision targeting, and regulatory evaluation remain major barriers to clinical translation. Future studies should balance therapeutic efficacy with standardized safety evaluation, biodegradable material design, and translational feasibility, while incorporating AI-assisted efficacy prediction and organoid-based preclinical evaluation to improve the predictability of carbon-based PTT before clinical application.