Exosomes是所有生物细胞自然产生的小的磷脂双层囊泡，包括原核生物与真核生物。由于其独特的大小、降低的免疫原性以及模仿合成类脂质体携带各种抗癌药物的能力，已被作为癌症治疗药物输送工具进行测试。开发Exosomes作为药物载体的另一个优点是轻松操作其内腔内容和表面修饰以实现肿瘤靶向药物输送。在过去的十年中，与癌症相关的Exosomes研究数量呈指数增长。预临床研究表明，Exosomes介导的化疗药物、生物制品和天然产物输送在体外和体内均产生强效的抗癌活性。相比之下，基于Exosomes的临床试验数量较少，这是由于制造和可扩展性方面的挑战，与Exosomes的大规模制造、存储和稳定性有关。在这里，我们讨论了近期前临床和临床研究中基于Exosomes的癌症治疗药物输送的最新进展，并总结了翻译更多基于Exosomes的治疗方案进入临床的挑战。版权所有©2023作者。由Elsevier B.V.出版，保留所有权利。

Exosomes are small phospholipid bilayer vesicles that are naturally produced by all living cells, both prokaryotes and eukaryotes. The exosomes due to their unique size, reduced immunogenicity, and their ability to mimic synthetic liposomes in carrying various anticancer drugs have been tested as drug delivery vehicles for cancer treatment. An added advantage of developing exosomes as a drug carrier is the ease of manipulating their intraluminal content and their surface modification to achieve tumor-targeted drug delivery. In the past ten-years, there has been an exponential increase in the number of exosome-related studies in cancer. Preclinical studies demonstrate exosomes-mediated delivery of chemotherapeutics, biologicals and natural products produce potent anticancer activity both, in vitro and in vivo. In contrast, the number of exosome-based clinical trials are few due to challenges in the manufacturing and scalability related to large-scale production of exosomes and their storage and stability. Herein, we discuss recent advances in exosome-based drug delivery for cancer treatment in preclinical and clinical studies and conclude with challenges to be overcome for translating a larger number of exosome-based therapies into the clinic.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.