Exosome-mimetic nanocarriers in cancer diagnosis and drug delivery: engineering strategies, functional biomimicry, safety considerations, and clinical translation

Cancer remains one of the leading causes of mortality worldwide, driving the development of advanced drug delivery systems to improve therapeutic selectivity and overcome the complex defense mechanisms of malignant cells. Exosome-mimetic nanocarriers (EMNs) have emerged as an advanced biomimetic platform for cancer diagnosis and targeted drug delivery, combining the biological functionality of natural exosomes with the manufacturing flexibility and scalability of synthetic nanocarriers. This review analyzes the composition, design, and architecture of EMNs, as well as their applications in cancer drug delivery, drawing on fundamental concepts of pharmaceutical technology to provide a translational perspective. It also includes a dedicated section on cancer diagnosis and theranostic platforms, as well as a critical analysis of recent technological advancements in exosome-mimetic systems. Although the clinical translation of natural exosomes remains limited, emerging evidence suggests that engineered EMNs offer improved scalability, reproducibility, and therapeutic versatility. Recent studies highlight their potential to overcome key limitations of natural vesicles, positioning them as promising candidates for future clinical translation and commercialization.