What is it about?

Vesicles, also known as "microparticles", are vesicle-like structures that are released outside the cell in a "sprouting" manner when the cytoskeleton is changed during cell activation or apoptosis, with a diameter of about 100-1000 nm, and are carriers of material information exchange between cells. Tumor-derived extracellular vesicles can effectively deliver drugs to the nucleus of tumor stem cells, thus effectively killing them without toxic side effects. The underlying mechanism involves the soft nature of tumor stem cells that allows better uptake of vesicles, and the entry of drug-carrying vesicles into lysosomes and facilitation of lysosomal movement toward the nucleus to deliver drugs to the nucleus. Drug-loaded vesicles have unique advantages, such as low immunogenicity, homing targeting ability, and the ability to break through the physiological barrier to tumor therapy. Tumor-derived drug-delivery vesicles have entered clinical trials for the treatment of malignant pleural effusions. In this review, we summarized the progress of basic and clinical research on tumor cell-derived drug-loaded vesicles for the treatment of malignant pleural effusion in recent years.

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Why is it important?

Tumor-derived extracellular vesicles have high objective efficacy, low adverse effects, good patient tolerance and can significantly improve patients' quality of life in the treatment of MPE. However, the advantages and disadvantages of autologous tumor cells and tumor cell lines as the parent cells for tumor-derived extracellular vesicles preparation need to be further clarified, and the occurrence of immune rejection of allogeneic tumor-derived extracellular vesicles should be sought. In addition, it would be valuable to further explore biomarkers to screen for populations of preference for MPE patients to benefit from tumor-derived extracellular vesicles therapy. Can the combination of tumor-derived extracellular vesicles and immune checkpoint inhibitors improve patient outcomes in oncology? Although such studies are still in the exploratory stage, tumor-derived extracellular vesicles have shown promising applications in tumor immunotherapy.

Perspectives

Most of the drugs currently available for clinical treatment of MPE are non-targeted, thus limiting the overall effect of the drugs. To solve this problem, drug delivery systems have emerged as a hot research topic in oncology therapy. An ideal drug delivery system can not only enhance drug efficacy, but also reduce the toxic side effects of drugs. It has been found that tumor cell-derived drug-loaded vesicles have the advantages of high cell affinity, high biocompatibility, high targeting, and specificity, and low immunogenicity, which can combine chemotherapy and immunotherapy and show a broad prospect in tumor therapy.

Rui Meng
Huazhong University of Science and Technology

Read the Original

This page is a summary of: Research progress of tumor‐derived extracellular vesicles in the treatment of malignant pleural effusion, Cancer Medicine, July 2022, Wiley,
DOI: 10.1002/cam4.5005.
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