| Summary: | Cancer is a group of diseases characterized by an abnormal growth of cells with an overwhelming potential for invasion and metastasis to other tissues of the body. False-negative or late diagnosis and the intrinsic potential of developing resistance against cancer treatments are prominent causes of low disease-free survival (DFS), overall survival (OS), and high recurrence rates in cancer patients. Several conventional regimens, such as chemotherapy, surgery, radiation, personalized therapy, hormone therapy, bone marrow transplant, and immunotherapy, are commonly employed for the treatment of cancer; however, the recent adaptation of nanotechnology has markedly improved the therapeutic outcomes of cancer. Exosomes are extracellular nanovesicles (50–150nm) secreted by different types of cells, including tumor and immune cells. Owing to their biological origin and unique functionalities, exosomes possess colossal potential for targeted delivery of a wide range of chemotherapeutics and immunotherapeutics for cancer treatment. Despite their low loading efficiency, exosomes have shown promising anticancer efficacy due to superior targeting efficiency, evasion from the reticuloendothelial system, prolonged plasm half-life, and promising ability of cell internalization. In this chapter, current challenges to cancer nanomedicines and the resolution of those challenges by implication of exosomes as cancer vaccines for the treatment of most prevalent types of cancer, such as lung, breast, and cervical cancers, have been pondered. Through understanding their biological function in cancer progression, exosomes can also be used as prognostic markers for monitoring of success of the prescribed cancer therapy. Despite their promising potential, exosome-based immunotherapy is still in the infancy stage for clinical translation due to the lack of specific international guidelines for isolation, purification, manufacturing, quality control, and application. © 2024 Elsevier Ltd. All rights reserved.
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