Gao Yanan, Qin You, Wan Chao, Sun Yajie, Meng Jingshu, Huang Jing, Hu Yan, Jin Honglin, Yang Kunyu
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2021 Mar 15;11:638357. doi: 10.3389/fonc.2021.638357. eCollection 2021.
Extracellular vesicles are small membrane particles derived from various cell types. EVs are broadly classified as ectosomes or small extracellular vesicles, depending on their biogenesis and cargoes. Numerous studies have shown that EVs regulate multiple physiological and pathophysiological processes. The roles of small extracellular vesicles in cancer growth and metastasis remain to be fully elucidated. As endogenous products, small extracellular vesicles are an ideal drug delivery platform for anticancer agents. However, several aspects of small extracellular vesicle biology remain unclear, hindering the clinical implementation of small extracellular vesicles as biomarkers or anticancer agents. In this review, we summarize the utility of cancer-related small extracellular vesicles as biomarkers to detect early-stage cancers and predict treatment outcomes. We also review findings from preclinical and clinical studies of small extracellular vesicle-based cancer therapies and summarize interventional clinical trials registered in the United States Food and Drug Administration and the Chinese Clinical Trials Registry. Finally, we discuss the main challenges limiting the clinical implementation of small extracellular vesicles and recommend possible approaches to address these challenges.
细胞外囊泡是源自各种细胞类型的小膜颗粒。根据其生物发生和货物成分，细胞外囊泡被广泛分类为外泌体或小细胞外囊泡。大量研究表明，细胞外囊泡调节多种生理和病理生理过程。小细胞外囊泡在癌症生长和转移中的作用仍有待充分阐明。作为内源性产物，小细胞外囊泡是抗癌药物的理想递送平台。然而，小细胞外囊泡生物学的几个方面仍不清楚，这阻碍了小细胞外囊泡作为生物标志物或抗癌药物的临床应用。在这篇综述中，我们总结了癌症相关小细胞外囊泡作为检测早期癌症和预测治疗结果的生物标志物的效用。我们还回顾了基于小细胞外囊泡的癌症治疗的临床前和临床研究结果，并总结了在美国食品药品监督管理局和中国临床试验注册中心注册的干预性临床试验。最后，我们讨论了限制小细胞外囊泡临床应用的主要挑战，并推荐了应对这些挑战的可能方法。
