Platinum (II) drugs, including cisplatin, carboplatin, and oxaliplatin, have achieved significant
clinical success in cancer treatment. However, their clinical application has been greatly
hindered by various adverse factors, such as non-specific activation and drug resistance. Compared
with Pt(II) drugs, the axial ligands within Pt(IV) compounds can improve the pharmacokinetic
properties, selectivity, and biological activity, implementing alternative cytotoxic mechanisms
beyond DNA cross-linking and partially overcoming drug resistance. The controlled conversion
of Pt(IV) prodrugs into Pt(II) agents at the tumor site has been extensively explored internationally.
In this review, Pt(IV) prodrug modification strategies are first summarized, and the development
of the predominant external and internal photosensitizers is listed. Finally, three representative
photoreduction mechanisms and strategies for developing corresponding Pt(IV) prodrugs
are discussed. This work provides constructive instruction for the subsequent molecular design of
Pt(IV) prodrugs.