外泌体是自然界中的细胞外纳米囊泡，直径为30-150纳米，具有与特定细胞相互作用和被摄取的能力。由于其生物相容性、在细胞外生物液中的生物稳定性和器官特异性，外泌体被探索用作生物医学递送系统和成像试剂。然而，其有用性、效力和临床应用受到某些关键参数的限制，包括需要更加稳健和可重复的制造过程、表征和质量控制评估以及临床研究。最近，类似外泌体的系统已成为克服天然外泌体限制的替代方案。这些系统基于表面工程方法和纳米级平台，相对于天然外泌体具有更深入的理解和更全面的标准化。通过将外泌体研究的最新知识与纳米技术的最有前途的发展相结合，类似外泌体系统可以作为创新的靶向抗癌治疗的竞争性方法发展。本综述旨在对设计和测试创新的类似外泌体系统和最有前途的转化为临床的疗法进行批判性概述，讨论这一领域的未来前景和挑战。版权所有 © 2023 Elsevier B.V.发表。

Exosomes are natural extracellular nanovesicles (30-150 nm in diameter) with the ability to interact with and be taken up by specific cells. They are being explored as delivery systems and imaging agents for biomedical purposes owing to their biocompatibility, biostability in extracellular biofluids, and organotropic properties. However, their usefulness, efficacy, and clinical application are limited by certain critical parameters, including the need for more robust and reproducible manufacturing processes, characterization, quality control assessment, and clinical studies. Recently, exosome-like systems have emerged as alternatives for overcoming the limitations of natural exosomes. These systems are based on surface engineering approaches and nanoscale platforms that offer a deeper understanding and allow for more exhaustive standardization compared with natural exosomes. By combining the latest knowledge related to exosome research with the most promising developments in nanotechnology, exosome-like systems can be developed as a competitive approach for innovative targeted anti-cancer therapies. This review aims to provide a critical overview of the latest advances in designing and testing innovative exosome-like systems and the most promising modalities that can be translated into the clinic. Future perspectives and challenges in this field are discussed.Copyright © 2023. Published by Elsevier B.V.