Glucose oxidase (GOx) is an endogenous oxido-
reductase that is widely distributed in living organisms. Over recent years, GOx has attracted increasing interest in the biomedical field due to its inherent biocompatibility, non-toxicity, and unique catalysis against β-
d-glucose. GOx efficiently catalyzes the oxidization of
glucose into
gluconic acid and
hydrogen peroxide (H2O2), which can be employed by various biosensors for the detection of
cancer biomarkers. Various
cancer therapeutic strategies have also been developed based on the catalytic chemistry of GOx: (1) the consumption of
glucose provides an alternative strategy for
cancer-
starvation therapy; (2) the consumption of
oxygen increases tumor hypoxia, which can be harnessed for
hypoxia-activated
therapy; (3) the generation of
gluconic acid enhances the acidity of the tumor microenvironment, which can trigger pH-responsive drug release; (4) the generation of H2O2 increases the levels of
tumor oxidative stress, and the H2O2 can be converted into toxic
hydroxyl radicals that can kill
cancer cells upon exposure to light irradiation or via the Fenton reaction. More importantly, GOx can be combined with other
enzymes,
hypoxia-activated
prodrugs,
photosensitizers or Fenton's
reagents, to generate multi-modal synergistic
cancer therapies based on
cancer starvation therapy,
hypoxia-activated
therapy, oxidation
therapy, photodynamic therapy, and/or
photothermal therapy. Such multi-modal approaches are anticipated to exert a stronger
therapeutic effect than one therapeutic mode alone. Thus, maximizing the potential of GOx in a biomedical context will offer novel clinical solutions to diagnose and treat
cancer. In this tutorial review, we introduce the recent advances of GOx in
cancer diagnosis and treatment. We then emphasize the design principles and biomedical applications of GOx-based biosensors and
cancer therapeutic approaches. Finally, we discuss the challenges and future prospects of GOx-based catalytic systems in biomedicine.