Xiao WZ, Shi JH. Exosomes in cancer: Functional mechanisms and therapeutic perspectives. World J Clin Oncol 2026; 17(3): 116823 [DOI: 10.5306/wjco.v17.i3.116823]
Corresponding Author of This Article
Wei-Zhang Xiao, PhD, Assistant Professor, Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, No. 20 Xisi Road, Chongchuan District, Nantong 226001, Jiangsu Province, China. xwz191201@163.com
Research Domain of This Article
Cell Biology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Mar 24, 2026; 17(3): 116823 Published online Mar 24, 2026. doi: 10.5306/wjco.v17.i3.116823
Exosomes in cancer: Functional mechanisms and therapeutic perspectives
Wei-Zhang Xiao, Jia-Hai Shi
Wei-Zhang Xiao, Jia-Hai Shi, Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
Author contributions: Xiao WZ designed the study, reviewed the references and analyzed all data; Shi JH edited the manuscript; Xiao WZ and Shi JH acquired the funding. All the authors have read and approved the final manuscript.
Supported by Jiangsu Provincial Research Hospital, No. YJXYY202204-YSB58.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Corresponding author: Wei-Zhang Xiao, PhD, Assistant Professor, Department of Cardiothoracic Surgery, Affiliated Hospital and Medical School of Nantong University, No. 20 Xisi Road, Chongchuan District, Nantong 226001, Jiangsu Province, China. xwz191201@163.com
Received: November 21, 2025 Revised: December 17, 2025 Accepted: January 26, 2026 Published online: March 24, 2026 Processing time: 122 Days and 18.9 Hours
Abstract
Exosomes are nano-sized extracellular vesicles that play a key role in intercellular communication. Due to their low immunogenicity, good biocompatibility, and tumor-targeting ability, they have shown great potential in cancer therapy. Their applications mainly include three aspects: Exerting direct antitumor effects through their endogenous cargo, serving as engineered drug delivery systems, and functioning as immunomodulators or cancer vaccines. In particular, exosomes derived from mesenchymal stem cells (MSCs) have been widely studied; however, their impacts on tumors are dual-sided, acting as either promoters or inhibitors depending on the context. This minireview summarizes the mechanisms of exosomes in cancer therapy, highlights the bidirectional role of MSC-derived exosomes, and discusses their clinical translation prospects.
Core Tip: This minireview elucidates the triple roles of exosomes in cancer therapy: As direct effectors, drug delivery vehicles, and immunomodulators. Focusing on mesenchymal stem cell-derived exosomes as a paradigm, it details their context-dependent, “double-edged sword” functionality in tumor regulation. The discussion extends to key translational challenges, including cargo complexity and manufacturing standardization, while highlighting engineering strategies as the critical path toward harnessing exosomes as potent, cell-free therapeutics.
