胰腺导管腺癌 (PDAC) 是一种极其致命的癌症，尽管进行了大量研究，但其 5 年生存率进展有限。治疗 PDAC 的主要挑战包括早期检测困难以及由于侵袭性分子和微环境特征而对当前治疗方法产生耐药性。这些挑战强调了识别经过临床验证的生物标志物以进行早期检测和临床管理的重要性。细胞外囊泡（EV），特别是外泌体，已成为运输分子货物的细胞间通讯的重要介质。最近的研究揭示了它们在 PDAC 的起始、转移和化疗耐药中的作用。因此，在液体活检中利用 EV 有望识别生物标志物，用于早期检测、预后和药物疗效监测。然而，许多限制，包括同质 EV 群体的分离和表征方面的挑战，以及缺乏标准化方案，可能会影响涉及 EV 作为生物标志物的研究的可靠性，这凸显了采取谨慎方法的必要性。 EV 作为一种有前途的药物输送系统和新型肿瘤疗法也引起了相当大的关注。将生物分子或化学药物装载到外泌体中并随后递送至靶细胞可以有效阻止肿瘤进展。然而，为了确保依靠 EV 治疗肿瘤的疗法的准确性和有效性，必须克服一些障碍。在这篇综述中，我们研究了最近的进展和仍然存在的障碍，探索利用电动汽车在生物标志物发现以及药物输送工具开发中的潜力。版权所有 © 2023 作者。由爱思唯尔有限公司出版。保留所有权利。

Pancreatic ductal adenocarcinoma (PDAC) is an extremely deadly form of cancer, with limited progress in 5-year survival rates despite significant research efforts. The main challenges in treating PDAC include difficulties in early detection, and resistance to current therapeutic approaches due to aggressive molecular and microenvironment features. These challenges emphasize the importance of identifying clinically validated biomarkers for early detection and clinical management. Extracellular vesicles (EVs), particularly exosomes, have emerged as crucial mediators of intercellular communication by transporting molecular cargo. Recent research has unveiled their role in initiation, metastasis, and chemoresistance of PDAC. Consequently, utilizing EVs in liquid biopsies holds promise for the identification of biomarkers for early detection, prognosis, and monitoring of drug efficacy. However, numerous limitations, including challenges in isolation and characterization of homogeneous EVs populations, as well as the absence of standardized protocols, can affect the reliability of studies involving EVs as biomarkers, underscoring the necessity for a prudent approach. EVs have also garnered considerable attention as a promising drug delivery system and novel therapy for tumors. The loading of biomolecules or chemical drugs into exosomes and their subsequent delivery to target cells can effectively impede tumor progression. Nevertheless, there are obstacles that must be overcome to ensure the accuracy and efficacy of therapies relying on EVs for the treatment of tumors. In this review, we examine both recent advancements and remaining obstacles, exploring the potential of utilizing EVs in biomarker discovery as well as for the development of drug delivery vehicles.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.