Dendrimers in precision oncology: advances in therapy, diagnostics, and translational prospects.

Dendrimers are highly branched nanoscale macromolecules with precisely tunable architectures that have emerged as transformative tools in cancer research. Their unique properties, such as high drug-loading capacity, multivalency, and surface tailoring ability, enable innovative applications in drug delivery, gene therapy, diagnostics, and immunotherapy. This review critically evaluates dendrimer performance against conventional nanocarriers, introduces a novel dendrimer-TME interaction matrix that classifies functions along cytotoxicity and microenvironment-modulation axes, and proposes actionable clinical-translation strategies. We critically evaluate their advantages over conventional nanocarriers, address challenges such as toxicity and scalability, and propose novel directions. Moreover, we identify persistent gaps in toxicity and scalability, emphasize stimuli-responsive systems, theranostics, and immune modulation, and outline how these advances could accelerate precision oncology while realistically discussing barriers to bedside translation.