Cancer therapeutic development is the most challenging domain in cancer. Cell-based cancer therapeutics come up with promising effectiveness. This approach was also cell-modified for better targeting efficiency development. Cell engineering-based cancer therapeutic is a cutting-edge method in cancer therapy. Due to complications of this process, cost and post-treatment side effects, this phenomenon came into the question mark. In this scenario, extracellular vesicle (EVs) research introduces a cell-free cancer therapeutic approach. In the therapeutic aspect most used EVs, come from stem cells, plants, and engineered cells. Among several EVs populations, Exosomes are the most used worldwide cell-free therapeutic tool for ageing cancer. The most interesting facts about exosomes are the biocompatible, non-immunoreactive, cross-biological barrier, and non-toxic (depending on the parental cell's nature). In this article, we are exploring modified exosomes (biological or chemical) that create a remarkable outcome in cancer therapeutic development compared to engineered cell-based therapeutics. Hope, in the future, modified exosomes become an effective, affordable, and specific cancer-targeting precision medicine.

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.