Precision Medicine: The Road to In Vivo Synthetic Therapeutic Agent

Abstract Precision medicine aims to optimize therapeutic efficacy while minimizing side effects, revolutionizing healthcare. This review explores the emerging field of in vivo synthetic therapeutic agents, where therapeutic molecules are synthesized directly within the body for highly targeted treatments. It highlights recent advances in in vivo synthesis techniques, including bioorthogonal click chemistry, microbial‐mediated synthesis, photo‐ and ultrasonic‐triggered synthesis, and artificial intelligence (AI)‐driven drug synthesis. Various synthesized products, such as nanoparticles, therapeutic gases (NO, H₂, CO, H₂S), chemical drugs, imaging agents, and AI‐synthesized pharmaceuticals, are discussed. The review also proposes integrating in vivo synthesis with in situ chimeric antigen receptor‐T cell therapy to enhance personalized medicine. AI‐assisted strategies are emphasized for accelerating the design and optimization of synthetic agents, improving therapeutic precision and efficiency. Additionally, key challenges, biosafety considerations, and future directions for in vivo synthetic therapeutic agents are addressed, offering a comprehensive perspective on their transformative role in the evolution of precision medicine.