This review synthesizes the utility of exhaled volatile organic compounds (VOCs) in cancer diagnosis, treatment efficacy prediction, and recurrence monitoring. As endogenous metabolic byproducts, VOCs enable noninvasive detection via technologies like gas chromatography-mass

spectrometry (GC-MS), electronic noses, selected ion flow tube mass spectrometry (SIFT-MS), and high-pressure photonionization time-of-flight mass spectrometry (HPPI-TOFMS).

Key findings include strong diagnostic performance (e.g., lung cancer AUC=0.95, hepatocellular carcinoma VOC sensitivity outperforming AFP)，accurate prediction of anti-PD-1/PD-L1 therapy response (AUC=0.89–0.97), and utility in colorectal cancer postoperative recurrence surveillance. Innovatively, it links VOC alterations to mechanisms (oxidative stress, CYP450 overexpression) and compares detection technologies’ strengths/limitations.

Clinical implications: VOCs address gaps of traditional biomarkers (low sensitivity/specificity)， while highlighting needs for standardized sampling/analysis protocols and improved device stability to advance clinical translation.

This review addresses cancer therapy limitations (systemic toxicity, multidrug resistance, MDR) via innovative nanoparticle (NP) platforms. Innovations include dual-phase liposomes (co-deliver hydrophilic/hydrophobic drugs, e.g., HA-functionalized ones for CD44⁺ brain tumors), green-synthesized metal NPs (low toxicity), MOF NPs (induce pyroptosis to boost immunity), and cell membrane-coated NPs (avoid RES clearance). It combines passive (EPR effect) and active (ligand-receptor) targeting.

Clinically, NPs reduce toxicity, enable delivery to hard-to-reach sites (e.g., brain), and overcome MDR. While long-term safety needs validation, NPs offer promise for personalized, less toxic oncology care.