Engineered and Targeted Exosomes for Cancer Therapy: Recent Preclinical Advances

Exosomes are nano-sized extracellular vesicles with intrinsic capabilities for intercellular communication, biocompatibility, and cargo protection, making them highly attractive as therapeutic delivery systems in oncology. In recent years, substantial progress has been made in engineering exosomes to enhance their therapeutic efficacy, targeting specificity, and in vivo stability. These engineered exosomes can be loaded with chemotherapeutic drugs, small interfering ribonucleic acids, microribonucleic acids, proteins, or gene-editing tools such as CRISPR/Cas systems. In parallel, surface modification strategies – including ligand conjugation, peptide display, and antibody engineering – have been developed to improve tumor homing and cellular uptake. This mini-review summarizes key preclinical advances from the past 5 years in engineered and targeted exosome-based cancer therapy. We focus on cargo-loading technologies, targeting strategies, biodistribution control, and therapeutic outcomes demonstrated across major cancer models. Current challenges and future translational perspectives are also discussed.