A tentative overview of exosomes and liposomes in clinical cancer research

Exosomes carry molecular signatures such as specific miRNAs, proteins, and lipids that can indicate the presence of cancer. Their accessibility in bodily fluids makes them valuable for non-invasive diagnostics, particularly useful for the early detection of cancers such as lung, colorectal, and pancreatic cancers. Furthermore, exosomal analysis allows clinicians to monitor disease progression and response to therapy by tracking changes in their molecular content over time. For example, a decrease in oncogenic miRNAs might suggest a positive response to chemotherapy. Exosomes are also at the forefront of liquid biopsy applications, offering a less invasive alternative to traditional tissue biopsies by reflecting the genetic and proteomic landscape of tumors, providing insights into mutations, resistance mechanisms, and the presence of cancer stem cells.

Exosomes can encapsulate various therapeutics, including chemotherapeutic agents, siRNAs, or miRNAs, to directly target cancer cells. This approach minimizes adverse effects on healthy tissues, as demonstrated with doxorubicin-loaded exosomes. Additionally, exosomes serve as gene therapy vectors, transferring genetic material that can either silence or activate specific genes at the molecular level. They can also be engineered to enhance immune responses against tumors by carrying antigens or immunomodulatory molecules, making them potential candidates for cancer vaccines and immunotherapy.

Studying exosomes provides valuable insights into cancer dynamics, including metastasis, drug resistance, and tumor heterogeneity. Researchers have discovered that exosomes facilitate the transfer of resistance-conferring molecules, shedding light on how cancers develop resistance to treatments. Additionally, exosomes from different tumor regions or patients reveal tumor heterogeneity, helping to develop better-targeted treatment strategies.

Despite their potential, exosomes pose safety concerns as tumor-derived exosomes may carry oncogenic material, necessitating careful engineering. Furthermore, scaling up to clinical-grade production remains a challenge due to variability in exosome isolation and loading techniques.