Strategies, Challenges and Application Prospects for Exosome Engineering Modifications in Tumor Targeted Therapeutics

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Nanodrugs have significantly revolutionized tumor therapy. Nevertheless, conventional nanodrug delivery systems suffer from a critical limitation: only ~0.7% of administered nanoparticles effectively accumulate in solid tumors, severely restricting clinical therapeutic efficacy. In recent years, exosomes-natural extracellular vesicles-have emerged as highly promising candidates for tumor-targeted drug delivery. Endowed with inherent low immunogenicity, excellent biocompatibility, and intrinsic capacity to traverse biological barriers, exosomes offer distinct advantages over conventional nanocarriers. Their characteristic lipid bilayer membrane not only protects encapsulated cargo but also enables surface engineering for functional optimization. Through strategic engineering modifications, exosomes can be endowed with enhanced tumor-targeting specificity, tunable payload release profiles, and multimodal functionalities, thus enabling the development of "smart" therapeutic platforms. This review systematically outlines current methodologies for exosome isolation and characterization, with a particular focus on engineering strategies aimed at augmenting tumor targeting. We comprehensively analyze approaches based on physical manipulation, chemical conjugation, and biological engineering. Furthermore, we summarize recent advances in exosome-based targeted cancer therapies and discu

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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