Autologous Cancer Cell-Derived Extracellular Vesicles as Drug-Delivery Systems: A Systematic Review of Preclinical and Clinical Findings and Translational Implications

Extracellular vesicles (EVs) are nanoscale natural membrane vesicles released by cells and are involved in intercellular communication. A number of studies have used autologous cancer cell-derived EVs (ACCD-EVs) as nanocarriers for delivery of therapeutics as they may be more efficiently uptaken by the cancer cells themselves. However, they also have been suggested to promote proliferation, survival and metastasis of cancers. Here, we evaluated the targeting efficacy, therapeutic outcome and safety of ACCD-EVs. Overall, superior targeting efficacy and enhanced anticancer efficacy of ACCD-EV-mediated delivery of therapeutics are evidenced. But existing data are insufficient to allow any conclusion about the safety of therapeutic-loaded EVs. A more profound elucidation of the specificity, efficacy and safety will contribute to future translational research of ACCD-EVs.