Clinical trial status of exosomes-based cancer theranostics

Abstract

Exosomes, are a subpopulation of extracellular vesicles, that originate from endosomes. The major role of exosomes is cellular communication (in this process exosomes display the status of the parental cell's nature, healthy or the cell suffers any pathological complication). In recent decades, research evidence highlighted that exosomes are the masterminds of cancer development and they appear as smart solutions for early diagnosis, prognosis and therapeutic (eg. stem cell, plant and immune cell-derived exosomes) approaches. Exosomes transform the cancer liquid biopsy into a new orientation. Several biofluids (blood, plasma, serum, saliva, urine, CSF (Cerebrospinal Fluid) and cancer tissue are used for exosome-based cancer biomarkers detection. Liquid biopsy becomes more efficient for exosomes, compared to tissue biopsy. Exosomes biocompatibility, low toxicity, and ability to cross biological membranes make it a potential tool for cancer therapeutic development. Exosome-based cancer therapeutics introduce a cutting-edge era of cell-free cancer therapy. This article explores the critical role of exosomes in cancer development, progression, treatment, and clinical trials. Exosome-based clinical trials indicate that we are close to cancer precision medicine.

Keywords

Biomarkers / Cancer / Clinical trial / Exosomes / Liquid biopsy / Therapeutic

References

[1] Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.

[2] Scioli MG, Terriaca S, Fiorelli E, et al. Extracellular vesicles and cancer stem cells in tumor progression: new therapeutic perspectives. Int J Mol Sci. 2021;22(19):10572.

[3] Tai YL, Chen KC, Hsieh JT, Shen TL. Exosomes in cancer development and clinical applications. Cancer Sci. 2018;109(8):2364-2374.

[4] Ghosh S, Dhar R, Gurudas Shivji G, et al. Clinical impact of exosomes in colorectal cancer metastasis. ACS Appl Bio Mater. 2023;6(7):2576-2590.

[5] Chowdhury R, Webber JP, Gurney M, Mason MD, Tabi Z, Clayton A. Cancer exosomes trigger mesenchymal stem cell differentiation into pro-angiogenic and pro-invasive myofibroblasts. Oncotarget. 2015;6(2):715-731.

[6] Richards KE, Zeleniak AE, Fishel ML, Wu J, Littlepage LE, Hill R. Cancer-associated fibroblast exosomes regulate survival and proliferation of pancreatic cancer cells. Oncogene. 2017;36(13):1770-1778.

[7] Li S, Yi M, Dong B, Jiao Y, Luo S, Wu K. The roles of exosomes in cancer drug resistance and its therapeutic application. Clin Transl Med. 2020;10(8):e257.

[8] Maqsood Q, Sumrin A, Saleem Y, Wajid A, Mahnoor M. Exosomes in cancer: diagnostic and therapeutic applications. Clin Med Insights Oncol. 2024;18:11795549231215966.

[9] Maqsood Q, Sumrin A, Saleem Y, Wajid A, Mahnoor M. Exosomes in cancer: diagnostic and therapeutic applications. Clin Med Insights Oncol. 2024;18:11795549231215966. Published 2024.

[10] Hussen BM, Faraj GSH, Rasul MF, et al. Strategies to overcome the main challenges of the use of exosomes as drug carrier for cancer therapy. Cancer Cell Int. 2022;22(1):323.

[11] Wu M, Wang G, Hu W, Yao Y, Yu XF. Emerging roles and therapeutic value of exosomes in cancer metastasis. Mol Cancer. 2019;18(1):53.

[12] Dhar R, Devi A. Engineered cell versus modified exosomes in cancer therapy. Clin Transl Disc. 2024;4(3):e320.

[13] Smyth T, Petrova K, Payton NM, et al. Surface functionalization of exosomes using click chemistry. Bioconjug Chem. 2014;25(10):1777-1784.

[14] Liang Y, Duan L, Lu J, Xia J. Engineering exosomes for targeted drug delivery. Theranostics. 2021;11(7):3183-3195.

[15] Zhang KL, Wang YJ, Sun J, et al. Artificial chimeric exosomes for anti-phagocytosis and targeted cancer therapy. Chem Sci. 2018;10(5):1555-1561.

RIGHTS & PERMISSIONS

2024 2024 The Author(s). Clinical and Translational Discovery published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics.