Gold Nanostars: Emerging Plasmonic Nanoplatforms for Lung Cancer Diagnosis and Therapy.

Lung cancer comprises two major histological subtypes, non-small cell lung cancer (NSCLC), which accounts for approximately 80-85% of cases, and small cell lung cancer (SCLC), representing 15-20%; this review discusses the theranostic potential of gold nanostars across both subtypes, with particular emphasis on NSCLC. Despite major improvements in surgery, chemotherapy, radiotherapy, and immunotherapy, therapeutic success remains limited by tumor heterogeneity, drug resistance, and the lack of reliable early detection biomarkers. Therefore, nanotechnology-based strategies are being explored as potential approaches for precision oncology. Gold nanostars have attracted considerable interest because of their anisotropic morphology, tunable localized surface plasmon resonance, and efficient photothermal conversion. In this review, we summarize the structural features, synthesis strategies, physicochemical properties, and emerging applications of gold nanostars in lung cancer diagnosis and therapy. Their plasmonic properties enable integration with imaging approaches, including surface-enhanced Raman spectroscopy, photoacoustic imaging, and computed tomography, as well as therapeutic modalities such as photothermal therapy, photodynamic therapy, and gene delivery. Surface functionalization may further enhance cellular uptake, targeting specificity, and therapeutic performance in selected experimental models. However, the available preclinical evidence remains heterogeneous, with outcomes influenced by nanostar size, morphology, surface chemistry, targeting strategy, administration route, and experimental model. Although several studies report enhanced tumor visualization or therapeutic responses, biodistribution remains variable, and a substantial fraction of administered nanoparticles may accumulate in organs such as the liver and spleen. Moreover, limited standardized head-to-head comparisons and insufficient long-term safety and clearance data prevent definitive conclusions regarding their overall superiority or clinical effectiveness. Gold nanostars therefore represent a promising but still investigational theranostic platform for lung cancer, with further standardized preclinical evaluation, long-term safety assessment, reproducible manufacturing, and well-designed clinical studies required to establish their translational potential.