Nanomaterial-based total analysis systems for isolation and detection of exosomal biomarkers in cancer diagnosis

Exosomes are nanoscale extracellular vesicles secreted by both cancerous and healthy cells that carry a diverse array of biomolecules, including nucleic acids and proteins, reflecting the physiological and pathological states of their cells of origin. This makes them highly promising biomarkers for liquid biopsy-based cancer diagnostics. However, conventional methods for exosome analysis from isolation to detection are often time-consuming, labor-intensive, and lack the sensitivity and specificity required for clinical applications. To address these limitations, nanomaterials are increasingly recognized as powerful tools for both exosome isolation and biomarker detection. Their unique physicochemical properties enable enhanced capture efficiency, precise molecular recognition, and signal amplification. In recent years, there has been increasing interest in developing nanomaterial-based total analysis systems (TAS) that seamlessly integrate exosome isolation and detection into unified, high-throughput diagnostic platforms. Consolidating the fragmented workflow into compact, high-throughput devices, these TAS hold strong promise for clinical and point-of-care (POC) applications. While previous reviews have primarily focused on either isolation or detection strategies, this work provides comprehensive overview dedicated to integrated nanomaterial-based TAS that combines both isolation and detection in a single platform. In this review, we discuss the biological relevance of exosome proteins and miRNAs as cancer biomarkers. We then examine nanomaterial-assisted strategies for exosome isolation and for signal transduction and amplification in exosome biomarker detection. Finally, we highlight newly developed TAS for exosome analysis, most reported in studies published between 2023 and 2025, emphasizing their potential for clinical application and POC applications. This review aims to establish a roadmap for future innovations in exosome-based diagnostics enabled by nanotechnology. To this end, we critically assess the current challenges and outline future directions, providing perspectives for their clinical translation.