Review uncovers exosomes' role in immunosuppression and cancer treatment, suggesting new therapeutic strategies.
Cancer immunotherapy, focusing on breaking tumor microenvironment (TME) immunosuppression, is limited by heterogeneity and drug resistance. Exosomes, 30–150 nm extracellular vesicles(EVs) carrying proteins, lipids, and noncoding RNAs, mediate intercellular communication and play dual roles in tumors. This review explores their multifaceted functions in cancer immunotherapy: in TME, tumor‐derived exosomes (TDEs) drive immunosuppression, cancer‐associated fibroblasts(CAFs) activation, and angiogenesis to promote progression and immune checkpoint inhibitors (ICIs) resistance; diagnostically, exosomal biomolecules (e.g., urinary miR‐424/423/660/let‐7i, serum LINC01125) serve as sensitive liquid biopsy markers for early detection and monitoring; therapeutically, engineered exosomes (e.g., DC‐derived antigen‐loaded ones) activate antitumor immunity and reverse ICIs resistance. These findings highlight exosomes' potential as diagnostic and therapeutic tools, laying a foundation for personalized cancer treatment.
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Wang et al. (2025) studied this question.
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