采用嵌合抗原受体的自然杀伤细胞（CAR-NK）促进了针对实体肿瘤和恶性肿瘤的现成细胞治疗。然而，由于其免疫监视的不确定性和细胞毒性的挑战，CAR-NK的发展受到了限制。源自自然杀伤细胞的外泌体（NK-Exo）结合了关键的靶向细胞治疗和具有非毒性特性的外泌体作为一种针对癌症免疫治疗的自身起源载体。本综述研究涵盖了来自NK细胞的细胞因子、NK免疫疗法的细胞治疗（同种异体和异种异体）的采用、刺激和调节功能以及NK细胞的细胞外衍生物。未来的研究路径将考虑NK-Exo细胞毒性和抗肿瘤活性，同时考虑非半胱氨酸依赖/依赖的凋亡以及Fas/FasL通路在癌症免疫治疗中的作用。最后，详细讨论了NK-Exo治疗的意义和影响，通过联合治疗以及纯化和输送NK-Exo到严重免疫和肿瘤细胞和组织的新兴方法的发展。© 2023年生物医学中心有限公司，斯普林格·自然集团的一部分。

Chimeric antigen receptor natural killer cells (CAR-NK) promote off-the-shelf cellular therapy for solid tumors and malignancy.However,, the development of CAR-NK is due to their immune surveillance uncertainty and cytotoxicity challenge was restricted. Natural killer cell-derived exosome (NK-Exo) combine crucial targeted cellular therapies of NK cell therapies with unique non-toxic Exo as a self-origin shuttle against cancer immunotherapy. This review study covers cytokines, adoptive (autologous and allogenic) NK immunotherapy, stimulatory and regulatory functions, and cell-free derivatives from NK cells. The future path of NK-Exo cytotoxicity and anti-tumor activity with considering non-caspase-independent/dependent apoptosis and Fas/FasL pathway in cancer immunotherapy. Finally, the significance and implication of NK-Exo therapeutics through combination therapy and the development of emerging approaches for the purification and delivery NK-Exo to severe immune and tumor cells and tissues were discussed in detail.© 2023. BioMed Central Ltd., part of Springer Nature.