Theranostic metallic nanoconjugates for colorectal cancer: targeting strategies, imaging modalities, and translational challenges.

INTRODUCTION: Colorectal cancer (CRC) remains a major global health burden, with high mortality largely driven by late diagnosis, limited tumor specificity of conventional therapies, and treatment-related toxicities. Innovative strategies are urgently needed to improve diagnostic precision and therapeutic selectivity.

AREAS COVERED: This review examines recent advances in metallic nanoparticle (MNP) - based theranostic systems for CRC, with particular emphasis on surface modification, ligand conjugation, tumor-targeting mechanisms, and integrated imaging - therapy platforms. A structured literature search was conducted in PubMed, Scopus, and Web of Science, covering publications from 2010 to 2025. The literature discussed encompasses in vitro studies, preclinical animal models, and emerging translational research, highlighting how physicochemical tuning and biological functionalization influence biodistribution, tumor uptake, and therapeutic response.

EXPERT OPINION: Although conjugated MNPs demonstrate substantial promise for image-guided and tumor-responsive therapy, their clinical translation remains constrained by biological heterogeneity, manufacturing complexity, regulatory uncertainty, and insufficient long-term safety data. Future progress will depend on simplified nanoplatform designs, clinically relevant disease models, and integration of real-time diagnostic feedback. Rather than replacing established treatments, MNP-based theranostics are most likely to emerge as precision adjuncts in selected CRC settings, shaping more adaptive and data-driven therapeutic paradigms.