Mesenchymal stem cell-based delivery systems for the treatment of brain tumors

Brain tumors rank among the most lethal cancer types, accounting for high mortality rates in both pediatric and adult populations. They present formidable therapeutic obstacles owing to their intrinsically aggressive biology, the complexity of their surrounding microenvironment, and the relatively poor efficacy of existing standard treatment modalities. Mesenchymal stem cells (MSCs) have garnered significant interest in oncology research due to their inherent ability to migrate selectively toward tumor sites and their versatility as delivery vehicles for a wide range of therapeutic agents. This review highlights the diverse therapeutic roles of MSCs and their derivatives, such as exosomes and engineered vectors, in brain tumor management. It encompasses key therapeutic strategies leveraging MSCs, including MSC-mediated delivery of chemotherapeutic agents, oncolytic viruses, and therapeutic genes; exosome-based interventions; nanotechnology-enhanced targeting precision; and the modulation of tumor behavior by engineered MSC-derived cytokines. Despite their promise, concerns remain regarding the potential for MSCs to promote tumor growth and the need for precise delivery systems. This review highlights the crucial need for additional research to refine MSC-based strategies, particularly through the rational engineering of MSCs and their derivatives for multimodal therapeutic applications, with the goal of enhancing specificity, efficacy, and safety in the treatment of malignant brain tumors.