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Extracellular Vesicles as Tailored Drug Delivery Systems in Cancer: Engineering Modifications and Therapeutic Synergies

Year: 2026

Type: review

Abstract: Extracellular vesicles (EVs) are nanoscale membrane-bound vesicles that mediate intercellular communication by transporting bioactive molecules, playing crucial roles in physiology and pathology. Recently, EVs have attracted considerable interest as drug delivery carriers for cancer therapy due to their biocompatibility, low immunogenicity, and intrinsic targeting capabilities. This review systematically summarizes EV biogenesis, classification, and characteristics, and thoroughly explores their applications in delivering chemotherapeutics, nucleic acids, and immunomodulators for cancer treatment. We emphasize engineering strategies to enhance EV targeting and therapeutic efficacy, including surface modification, cell source selection, and drug loading techniques. Additionally, we evaluate recent advances in overcoming tumor drug resistance and achieving combinational therapies, such as chemo-photothermal-immunotherapy, using EV platforms. Finally, we examine critical challenges hindering clinical translation, including standardized production, quality control, and scalable manufacturing. This comprehensive analysis aims to provide theoretical insights and practical guidance for developing EVs as next-generation drug delivery systems in cancer therapy.

Source: International Journal of Nanomedicine

DOI: 10.2147/ijn.s627425