Exosome-based immunotherapy as an innovative therapeutic approach in melanoma

Abstract

The malignant form of melanoma is one of the deadliest human cancers that accounts for almost all of the skin tumor-related fatalities in its later stages. Achieving an exhaustive understanding of reliable cancer-specific markers and molecular pathways can provide numerous practical techniques and direct the way toward the development of rational curative medicines to increase the lifespan of patients. Immunotherapy has significantly enhanced the treatment of metastatic and late-stage melanoma, resulting in an incredible increase in positive responses to therapy. Despite the increasing occurrence of melanoma, the median survival rate for patients with advanced, inoperable terminal disease has increased from around six months to almost six years. The current knowledge of the tumor microenvironment (TME) and its interaction with the immune system has resulted in the swift growth of innovative immunotherapy treatments. Exosomes are small extracellular vesicles (EVs), ranging from 30 to 150 nm in size, that the majority of cells released them. Exosomes possess natural advantages such as high compatibility with living organisms and low potential for causing immune reactions, making them practical for delivering therapeutic agents like chemotherapy drugs, nucleic acids, and proteins. This review highlights recent advancements in using exosomes as an approach to providing medications for the treatment of melanoma.

Keywords: Cancer vaccine; Drug delivery; Drug resistance; Exosome therapy; Melanoma.

Fig. 1

Current therapy methods in melanoma. (A) Targeted therapy, (B) Immune checkpoint inhibitors, (C) Adoptive cell therapy, (D) Oncolytic virus therapy, (E) Cancer vaccine (created by bio render)

Fig. 2

Exosome-based immunotherapy in melanoma. Exosome-based therapy in melanoma mainly employs three general methods. (1) Genetic engineering initiates the alterations, allowing the targeted gene to infiltrate the cell via a plasmid, multiply within it, and subsequently release it from the cell via exosomes. (2) Exosome surface modifications involve the use of linkers to introduce materials like antibodies and adhesive molecules onto the exosome’s surface, enabling the exosome to adhere specifically to the target cell. (3) The process involves importing cargo, such as chemotherapy drugs and antigens, and delivering them to the desired cell using mechanical and chemical methods. Modified exosomes can enter the tumor microenvironment and affect various immune cells. For example, in the presence of adjuvants, they can switch macrophages to M1, increase antibody efficacy and T-cell stimulation, enhance dendritic cell maturation, and ultimately increase the immune system’s response to a tumor.