快速发展的畸变细胞越过其正常范围，随后可以感染其他身体部位并扩散到其他器官——这个过程被称为转移，是癌症的一个重要特征之一。癌症患者死亡的主要原因是广泛的转移。这种异常细胞增殖在100多种癌症中都有所不同，它们对治疗的反应也会有很大的变化。虽然已经发现了几种抗癌药物来治疗各种肿瘤，但它们仍然有有害的副作用。基于肿瘤细胞的分子生物学改变找到新的、高效的靶向治疗方法对于减少对健康细胞的不加选择的破坏是至关重要的。外泌体是一种细胞外囊泡，由于它们在身体内有良好的耐受性，因此被认为是癌症治疗的一种有前途的药物载体。此外，肿瘤微环境是癌症治疗中潜在的调节目标。因此，巨噬细胞被极化成M1和M2表型，这涉及到癌症增殖和恶性肿瘤。最近的研究表明，控制巨噬细胞的极化方式，可能通过使用miRNA的直接方式来促进癌症治疗。这篇综述提供了一种利用外泌体来发展“间接”、更自然、更无害的癌症治疗方法，通过调节巨噬细胞的极化。

The rapid development of aberrant cells outgrowing their normal bounds, which can subsequently infect other body parts and spread to other organs-a process known as metastasis-is one of the significant characteristics of cancer. The main reason why cancer patients die is because of widespread metastases. This abnormal cell proliferation varies in cancers of over a hundred types, and their response to treatment can vary substantially. Several anti-cancer drugs have been discovered to treat various tumors, yet they still have harmful side-effects. Finding novel, highly efficient targeted therapies based on modifications in the molecular biology of tumor cells is essential to reduce the indiscriminate destruction of healthy cells. Exosomes, an extracellular vesicle, are promising as a drug carrier for cancer therapy due to their good tolerance in the body. In addition, the tumor microenvironment is a potential target to regulate in cancer treatment. Therefore, macrophages are polarized toward M1 and M2 phenotypes, which are involved in cancer proliferation and are malignant. It is evident from recent studies that controlled macrophage polarization might contribute to cancer treatment, by the direct way of using miRNA. This review provides an insight into the potential use of exosomes to develop an 'indirect', more natural, and harmless cancer treatment through regulating macrophage polarization.