Recent progress of dendritic cell-derived exosomes in tumor immunotherapy

Despite advancements in conventional tumor therapies including surgery and chemotherapy, effective cancer management remains challenging due to treatment resistance and tumor microenvironment complexity. Dendritic cell (DC)-based vaccines, while representing a milestone in tumor immunotherapy, face clinical limitations such as poor viability and limited antigen presentation capacity. Importantly, dendritic cell-derived exosomes (DEXs) have emerged as a potential alternative. In contrast to DC vaccines, DEXs possess excellent in vivo biocompatibility and biosafety, demonstrate higher immunogenicity, exhibit stronger immunosuppressive resistance, and require lower production costs. Mechanistically, DEXs overcome immunosuppressive obstacles through dual delivery of immunostimulatory cargo and tumor-associated antigens, thereby achieving superior anti-tumor effects. This review examines recent research progress regarding DEXs in tumor immunotherapy, with particular emphasis on their roles in immune activation, the regulation of the tumor microenvironment, serving as drug delivery vehicles, and vaccine development. These advancements will help deepen the understanding of tumor immunotherapy and promote clinical translation.