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Drug-Loaded Extracellular Vesicle-Based Drug Delivery: Advances, Loading Strategies, Therapeutic Applications, and
Linh Le Dieu1, Adrienn Kazsoki1, Romána Zelkó1
1University Pharmacy Department of Pharmacy Administration, Semmelweis University, Hőgyes Endre Street 7-9, 1092 Budapest, Hungary.
Pharmaceutics
|January 28, 2026
Summary
Drug-loaded extracellular vesicles (EVs) show promise for drug delivery, but clinical translation faces hurdles. Standardization and large-scale studies are crucial for advancing EV-based therapeutics.
Area of Science:
- Biotechnology
- Nanomedicine
- Drug Delivery Systems
Background:
- Extracellular vesicles (EVs) are biocompatible nanocarriers with potential for drug delivery.
- Clinical translation of drug-loaded EVs is limited due to various challenges.
- A systematic review was conducted to analyze current research on drug-loaded EVs.
Purpose of the Study:
- To summarize evidence on EV sources, loading strategies, and therapeutic applications.
- To identify challenges hindering the clinical translation of drug-loaded EVs.
- To review the current landscape of drug-loaded EV research from 2020-2025.
Main Methods:
- Systematic literature search following PRISMA 2020 guidelines across major databases (Embase, PubMed, Reaxys, Scopus).
- Inclusion of original articles on drug-loaded EVs from diverse sources (human, animal, plant).
- Extraction of data on EV characteristics, loading methods, administration, and therapeutic outcomes, including clinical trials.
Main Results:
- Human mesenchymal stem cell (MSC)-derived EVs were common in oncology; plant-derived EVs in other applications.
- Commonly loaded drugs included anti-cancer agents (doxorubicin, gemcitabine) and natural compounds (curcumin, berberine).
- Intravenous administration and passive loading predominated, showing enhanced efficacy; two clinical trials indicated preliminary benefits.
Conclusions:
- Drug-loaded EVs offer a versatile platform for drug delivery.
- Clinical translation is impeded by variability in EV isolation, loading, scalability, and safety evaluation.
- Standardization and large-scale studies are essential for advancing EV therapeutics.
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