Abstract
Cancer remains one of the leading causes of mortality worldwide and continues to pose significant therapeutic challenges despite decades of research. Conventional treatments such as chemotherapy and radiotherapy often lack selectivity, damaging both malignant and healthy tissues and resulting in severe side effects. Photodynamic therapy (PDT) has emerged as a promising non-invasive alternative that selectively eradicates cancer cells or pathogens using a photosensitizer (PS), light, and oxygen. PDT induces necrosis or apoptosis in cancer cells by locally generating cytotoxic reactive oxygen species through targeted laser irradiation. However, its clinical efficacy is limited by factors such as tumor hypoxia, poor PS delivery efficiency, and light attenuation within biological tissues. Recent advances in liposomal nanoplatforms have shown considerable potential in overcoming these barriers. Liposomes can co-deliver PS, therapeutic agents, and oxygen, thereby enhancing PDT outcomes. This review outlines the fundamental principles of PDT and the physicochemical properties of liposomes. It then explores two major strategies for improving PDT efficacy using liposomes: PS-drug co-delivery and oxygen delivery to mitigate tumor hypoxia for synergistic therapeutic effects. Finally, current limitations and future perspectives of liposome-based nanomedicine in photodynamic cancer therapy are discussed. Overall, this review provides a foundation for advancing liposome-based strategies toward clinical implementation in photodynamic cancer treatment.