Progress of Exosomes in Cancer Immunotherapy

Cancer immunotherapy, focusing on breaking tumor microenvironment (TME) immunosuppression, is limited by heterogeneity and drug resistance. Exosomes, 30-150 nm extracellular vesicles(EVs) carrying proteins, lipids, and noncoding RNAs, mediate intercellular communication and play dual roles in tumors. This review explores their multifaceted functions in cancer immunotherapy: in TME, tumor-derived exosomes (TDEs) drive immunosuppression, cancer-associated fibroblasts(CAFs) activation, and angiogenesis to promote progression and immune checkpoint inhibitors (ICIs) resistance; diagnostically, exosomal biomolecules (e.g., urinary miR-424/423/660/let-7i, serum LINC01125) serve as sensitive liquid biopsy markers for early detection and monitoring; therapeutically, engineered exosomes (e.g., DC-derived antigen-loaded ones) activate antitumor immunity and reverse ICIs resistance. These findings highlight exosomes' potential as diagnostic and therapeutic tools, laying a foundation for personalized cancer treatment.