Mesenchymal stem cell-derived exosome-inspired nanoformulations: a new frontier in targeted cancer therapy

Mesenchymal stem cell (MSC)-derived exosome-inspired nanoformulations have recently been proposed as an emerging approach for targeted cancer therapies, which overcome the limitations of conventional cancer therapies, such as low tumor selectivity, systemic toxicity, and the development of drug resistance. Exosomes, particularly MSC-derived exosomes, are known to offer an efficient and biocompatible approach for the targeted delivery of various therapeutic agents, including chemotherapeutic agents, to the tumor site. Here, we provide an integrative review on the unique aspects of MSC-derived exosomes (MSCEs)-inspired nanoformulations, including their tumor-targeting strategies, such as chemotaxis, receptor-mediated uptake, immune escape, and intracellular delivery, as well as their implications in cancer cell signaling. Further, the recent developments in the fabrication of bioengineering approaches for exosomes and the application of exosome-mimetic nanocarriers are also critically evaluated. In addition to therapeutic applications encompassing chemotherapy, RNA-based therapies, immunomodulation, and combination approaches, we provide a balanced discussion of the advantages, limitations, and key challenges related to large-scale production, standardization, and regulatory translation. Collectively, this review offers a unified framework bridging biological mechanisms and nanotechnological engineering, positioning MSCEs-inspired nanoformulations as next-generation platforms for precision oncology.