Extracellular vesicle-based vaccines and immunotherapeutics for treatment of cancer

In recent years, cancer immunotherapy has gained substantial momentum, particularly in the field of vaccines and immunotherapeutics. Among these advancements, extracellular vesicles (EVs) have emerged as a promising cell-free vaccine system due to their unique capacity to display diverse antigens and immune-stimulatory molecules. Additionally, their excellent biocompatibility, ability to permeate across biological barriers, and targeting properties make EVs a promising platform for delivery of various therapeutics for cancer immunotherapy, such as RNAs, proteins, lipids, and chemotherapeutic agents. To date, EV-based vaccines and immunotherapeutics have demonstrated remarkable efficacy in combating various types of cancers. Herein, we endeavor to give a comprehensive summary of EV-based vaccines and immunotherapeutics for the treatment of cancers, delving into their advantages and challenges. Furthermore, emphasis was given on offering insight into the design rationale of each platform. Lastly, we recapitulate the recent preclinical and clinical application progress of EV-based vaccines and immunotherapeutics, highlighting their pivotal role in cancer immunotherapy.