Crosstalk between ferroptosis and extracellular vesicles in cancer: from interaction to clinical application

Cancer continues to pose a significant issue to public health. Despite the considerable advancements in popular therapies such as surgery, radiation, chemotherapy, targeted therapy, and immunotherapy, a substantial number of patients continue to suffer from cancer due to severe treatment resistance. As a result, it is imperative to have a deeper understanding of the mechanisms behind cancer growth and therapy resistance. Ferroptosis, an iron-dependent form of cell death characterized by excessive lipid peroxidation, has recently been described, attracting heightened interest in its implications in cancer. Ferroptosis offers a new conceptual framework for understanding cancer progression. Some treatments function via regulating ferroptosis, and the tough insensitive to various therapies also involves ferroptosis resistance. Hence, targeting ferroptosis may benefit the cancer treatments. Extracellular vesicles (EVs) are essential mediators in cell-to-cell communications and are significantly impacted by environmental or cellular stress. The relationship between EVs and ferroptosis has recently been steadily demonstrated, and it has also been possible to use EVs to target ferroptosis to treat cancer. We present a novel perspective on cancer by reexamining the existing knowledge of ferroptosis and EVs in this disease. This includes a comprehensive overview of the relationships between ferroptosis and EVs and their therapeutic applications, focusing on contemporary ferroptosis-targeting EVs in the context of cancer.