Extracellular Vesicle-Based Therapeutic Cargo Delivery for Cancer Therapy

Zhiben Huang,1,* Jiaqing Cheng,2,* Zhimin Deng,1 Chunjiang Liu,1 Tianying Huang,2 Wansong Lin3,4 1College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, People’s Republic of China; 2The School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, 350122, People’s Republic of China; 3Laboratory of Immuno-Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, 350014, People’s Republic of China; 4Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, 350014, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wansong Lin, Laboratory of Immuno-Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, 350014, People’s Republic of China, Email [email protected]: Extracellular vesicles (EVs) have become attractive nanoscale delivery systems in oncology because of their inherent biological advantages and distinct physicochemical properties. These cell-derived nanoparticles exhibit low immunogenicity, inherent targeting capacities, and the natural ability to facilitate precise intercellular transfer of bioactive molecules, including proteins and nucleic acids. Recently, remarkable progress has been made in EV engineering. These advancements have improved the accuracy and efficiency of delivering therapeutic agents to tumor sites. In this review, we outline the biogenesis, composition, and unique advantages of EVs compared with conventional nanocarriers, with an emphasis on their therapeutic potential in cancer treatment. Furthermore, we discuss EV cargo–loading methods and advanced engineering approaches designed to enhance tumor-specific targeting. In addition, we systematically summarize diverse therapeutic applications, including chemotherapeutic drug delivery, nucleic acid–based therapies, cancer vaccines, and multifunctional theranostic platforms. The review also discusses current clinical trials and highlights the critical challenges in clinical translation, such as limited clinical-scale manufacturing and unclear regulatory pathways. Future efforts to overcome these challenges could transform EVs into precise and personalized tools for cancer treatment. This concise overview provides valuable insights into the current developments and future perspectives of EV-mediated therapeutic delivery systems in oncology.Keywords: nanocarriers, drug loading, targeted delivery, immunotherapy, clinical translation