Developing effective nanomedicines for pulmonary metastasis remains challenging because of systemic clearance and local stromal barriers. Guided by single-cell transcriptomic profiling, we characterized a compartmentalized immunosuppressive network involving PGE2 and provide a biological rationale for coordinated EP2/EP4 antagonism. We therefore engineered an inhalable biomimetic platform (PD-1@E2/4 Exo) comprising PD-1-displaying exosomes co-loaded with EP2 and EP4 antagonists. Compared with intravenous administration, nebulized delivery increased pulmonary exposure of the engineered vesicles. Within the pulmonary tumor setting, surface PD-1 is intended to interfere with PD-1/PD-L1 signaling, while the co-delivered antagonists target the EP2/EP4 immunosuppressive axis. Treatment was associated with macrophage reprogramming, increased oxidative stress, and enhanced ICD-related responses in tumor cells. In the experimental breast-cancer lung-colonization model, the inhaled formulation reduced established pulmonary tumor burden and was accompanied by systemic immune-memory responses. These findings provide a preclinical study for integrating local pulmonary delivery with coordinated metabolic and immune modulation in breast cancer lung disease.
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Li et al. (2026) studied this question.
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