Figure 1.

Schematic illustration of the sonotheranostic action of dual pH/US-responsive EVs co-encapsulating ICG, PTX, and SBC. Once the EVs enter the cancer cells via endocytosis, the acidic pH in the endo/lysosomes facilitates the release of ICG and PTX owing to bursting effects triggered by the generation of CO₂ bubbles from the SBC. After the cytoplasmic release of ICG and PTX, US irradiation triggers sonodynamic effects by generating intracellular ROS, subsequently triggering the apoptosis of breast cancer cells. The ICG-loaded EVs generate PA imaging signals, thus enabling PA imaging-guided chemo-sonodynamic combination cancer therapy.