Ideas and possible mechanisms of algae in tumor therapy. (A) Algae-based composite nanoparticles loaded with photodynamic chemotherapeutic immunomodulation to enhance tumor oxygenation and stimulate anticancer immune responses for cancer therapy. Aggregates specifically at the tumor site and penetrates flexibly into the tumor mass, thereby increasing the oxygenation state of the tumor. Adapted with permission from American Chemical Society: ACS Nano, Oxygen-delivering polyfluorocarbon nanovehicles improve tumor oxygenation and potentiate photodynamic-mediated anticancer immunity. Wang Z, Gong X, Li J, et al. Copyright© 2021 ACS Nano.71 (B) Possible mechanism of engineered algae-mediated combination therapy: Reduced HIF1 and VEGF protein levels promote apoptosis and necrosis. Reprinted from Qiao Y, Yang F, Xie T, et al. Engineered algae: A novel oxygen-generating system for effective treatment of hypoxic cancer. Science Advances. 2020;6(21):eaba5996. Creative Commons.24 (C) Engineered algae-mediated RT and PDT can effectively inhibit tumor growth after intravenous injection. Average cancer growth curve. (1, control; 2, laser alone; 3, RBCM-Algae alone; 4, x-ray irradiation (RT) alone; 5, RT + laser; 6, RBCM-Algae + laser; 7, RBCM-Algae + RT; and 8, RBCM-Algae + RT + laser. Student’s two-tailed t test, not significant P ≥ 0.05; *P < 0.05; ***P < 0.001; photodynamic therapy (PDT); red blood cell membrane (RBCM)). Reprinted from Qiao Y, Yang F, Xie T, et al. Engineered algae: A novel oxygen-generating system for effective treatment of hypoxic cancer. Science Advances. 2020;6(21):eaba5996. Creative Commons.24 (D) Kaplan‒Meier curve showing the survival rate of the indicated rabbits at 140 days. (near-infra-red (NIR), photosynthesis microcapsule (PMC), the data are presented as *p < 0.05). Nat Commun. 2022 Aug 2;13(1):4495. Open Access.48 (E) A regimen in which engineered algae-mediated RT and PDT can effectively inhibit tumor growth after intravenous injection. Reprinted from Qiao Y, Yang F, Xie T, et al. Engineered algae: A novel oxygen-generating system for effective treatment of hypoxic cancer. Science Advances. 2020;6(21):eaba5996. Creative Commons.24 (F) Effect of algae in a hyperoxic microenvironment on cancer. Representative axial CT images of tumor growth. (near-infra-red (NIR), photosynthesis microcapsule (PMC)). Reprinted from Wang W, Zheng H, Jiang J, et al. Engineering micro oxygen factories to slow tumor progression via hyperoxic microenvironments. Nature communications. 2022;13(1):4495. Creative Commons.48