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Review
. 2025 Feb 18;19(6):5871-5896.
doi: 10.1021/acsnano.4c11630. Epub 2025 Jan 27.

Natural and Bioengineered Extracellular Vesicles in Diagnosis, Monitoring and Treatment of Cancer

Xin Luo  1   2 , Kathleen M McAndrews  1 , Raghu Kalluri  1   2   3
Affiliations
Review

Natural and Bioengineered Extracellular Vesicles in Diagnosis, Monitoring and Treatment of Cancer

Xin Luo et al. ACS Nano. .

Abstract

Extracellular vesicles (EVs) are cell derived nanovesicles which are implicated in both physiological and pathological intercellular communication, including the initiation, progression, and metastasis of cancer. The exchange of biomolecules between stromal cells and cancer cells via EVs can provide a window to monitor cancer development in real time for better diagnostic and interventional strategies. In addition, the process of secretion and internalization of EVs by stromal and cancer cells in the tumor microenvironment (TME) can be exploited for delivering therapeutics. EVs have the potential to provide a targeted, biocompatible, and efficient delivery platform for the treatment of cancer and other diseases. Natural as well as engineered EVs as nanomedicine have immense potential for disease intervention. Here, we provide an overview of current knowledge of EVs' function in cancer progression, diagnostic and therapeutic applications for EVs in the cancer setting, as well as current EV engineering strategies.

Keywords: Extracellular vesicles (EVs); cancer; cancer immunotherapy; cargo loading methods; diagnosis; drug delivery; immune microenvironment; large scale production; monitoring; tumor microenvironment (TME).

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Conflict of interest statement

Conflict of interest

MD Anderson Cancer Center has patents licensed to PranaX for non-cancer related use. MD Anderson Cancer Center and Raghu Kalluri report a relationship with PranaX for non-cancer related activities that includes, consulting or advisory and equity or stocks. Raghu Kalluri is a SAB member of Xsome Biotech Inc. and a stockholder and advisor to Transcode Therapeutics.

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