Efficient production of extracellular vesicles for enhanced cancer immunotherapy

Extracellular vesicles (EVs) carry proteins, nucleic acids, lipids, and metabolites that originate in donor cells and function as essential mediators of intercellular communication. Their biological functions are closely associated with the characteristics of their cellular origin. EVs secreted by immune cells promote the priming and targeted recruitment of T cells by delivering MHC proteins, co-stimulation signals, inflammatory cytokines, and chemokines while inducing tumor cell apoptosis via DNA damage and oxidative stress. EVs released from tumor cells enhance anti-cancer immunity by transporting tumor-associated antigens and double-stranded DNA, stimulating dendritic cell maturation and activating the cGAS-STING signaling pathway. Although EVs show broad potential in immune modulators, cancer vaccines, drug formulations, and diagnosis agents, their practical application is limited by low natural yield and the difficulty of preserving bioactivity during isolation and storage. This review highlights the immunological functions of EVs in cancer therapy, recent progress in engineered EV production, and emerging strategies for enhancing their therapeutic potential.