Covalent organic frameworks as multifunctional nanoplatforms for precise cancer therapy: design principles, applications, and future perspectives

Cancer remains a major global health challenge, as existing therapies are constrained by systemic toxicity, limited specificity, and the emergence of resistance. Conventional nanocarriers often struggle to address significant barriers such as tumor heterogeneity, multidrug resistance, immunosuppressive microenvironments, and the integration of multimodal treatments, thereby limiting their overall clinical efficacy. In this context, covalent organic frameworks (COFs)—a class of crystalline porous materials constructed from light elements via robust covalent bonds—emerge as a versatile platform characterized by tunable porosity, high crystallinity, and exceptional chemical stability. Their tunable framework structure facilitates multifunctional integration, enabling precise tumor targeting, controlled drug release, and synergistic multimodal therapies. This minireview summarizes the design principles and diverse applications of COFs in tumor therapy, covering treatment modalities. Next, we systematically present the capabilities of COFs as biomolecular carriers, emphasizing their excellent loading capacity and biocompatibility. Furthermore, we explore the development of multifunctional COF-based therapeutic platforms, focusing on their innovative applications in combination therapy, nanotheranostics, and nanozymes for precise tumor treatment. Finally, a concise summary and outlook are provided.