Transforming native exosomes to engineered drug vehicles: A smart solution to modern cancer theranostics

Exosomes have been the hidden treasure of the cell in terms of cellular interactions, transportation and therapy. The native exosomes (NEx) secreted by the parent cells hold promising aspects in cancer diagnosis and therapy. NEx has low immunogenicity, high biocompatibility, low toxicity and high stability which enables them to be an ideal prognostic biomarker in cancer diagnosis. However, due to heterogeneity, NEx lacks specificity and accuracy to be used as therapeutic drug delivery vehicle in cancer therapy. Transforming these NEx with their innate structure and multiple receptors to engineered exosomes (EEx) can provide better opportunities in the field of cancer theranostics. The surface of the NEx exhibits numeric receptors which can be modified to pave the direction of its therapeutic drug delivery in cancer therapy. Through surface membrane, EEx can be modified with increased drug loading potentiality and higher target specificity to act as a therapeutic nanocarrier for drug delivery. This review provides insights into promising aspects of NEx as a prognostic biomarker and drug delivery tool along with its need for the transformation to EEx in cancer theranostics. We have also highlighted different methods associated with NEx transformations, their nano-bio interaction with recipient cells and major challenges of EEx for clinical application in cancer theranostics. The native exosomes (NEx) released by the parent cells hold promising aspects in cancer theranostics. But, due to heterogeneity, NEx have shown low tropism, low cargo efficiency, uncontrolled biodistribution, low biocompatibility and lacks specificity as well as accuracy to be used as a therapeutic drug delivery vehicle in cancer therapy. However, these NEx can be transformed to engineered exosomes (EEx) through their surface modifications by chemical and genetic techniques. The EEx would offer high cargo loading, show low toxicity, longer half-life time, high biocompatibility and are target specificity. These EEx can be targeted as a prognostic biomarker and drug delivery tool in cancer diagnosis and therapy. image