Translational Progress of Inorganic Nanotheranostic Platforms for Gynecologic Malignancies: A Narrative Review of Endometrial, Ovarian, and Cervical Cancer Focusing on Fertility Preservation, Biosafety, and Industrial Translation.

Endometrial, ovarian, and cervical cancers differ substantially in epidemiology, anatomy, and unmet clinical need, yet the same inorganic nanomaterial toolbox is often discussed without disease-specific translational context. This narrative review synthesizes preclinical and clinical literature on gold, magnetic, mesoporous silica, carbon-based, and metal-organic framework nanotheranostic platforms identified through PubMed and Web of Science searches from database inception through August 2026, using a structured comparison across endometrial, ovarian, and cervical cancer. Particular attention is given to biosafety, reproductive toxicity, patient-derived organoid (PDO) models, AI-assisted design, manufacturing, and regulatory translation. Clinically, carbon nanoparticle suspensions have direct evidence for sentinel lymph node mapping in endometrial cancer, whereas the strongest ovarian cancer precedents for locoregional and nanomedicine delivery remain non-inorganic, including hyperthermic intraperitoneal chemotherapy and pegylated liposomal doxorubicin. In cervical disease, organic hexaminolevulinate photodynamic therapy for CIN2, approved by China's NMPA in March 2026, provides a relevant local drug-device comparator. We identified no inorganic nanomedicine currently approved specifically for a gynecologic malignancy; ferumoxytol is approved as an intravenous iron replacement product, and AuroLase gold nanoshells remain investigational, with no gynecologic trial identified. Route-matched delivery - intrauterine or hysteroscopic for endometrial cancer, intraperitoneal for ovarian cancer, and topical or intracervical for cervical disease - may therefore be more clinically relevant than increasing platform complexity alone. EC- and OC-derived organoids provide increasingly mature disease models that could support nanotherapeutic screening, but direct nanomedicine validation remains limited, while AI-assisted design is constrained by small heterogeneous datasets and limited external validation. Future progress will depend on reproductive-safety endpoints, appropriately validated PDO models, standardized manufacturing and characterization, and regulatory strategies that clearly distinguish established evidence from preclinical promise.