[Mesenchymal Stem Cells as Anti-Tumor Therapeutics-Current Status and Challenges]

Mesenchymal stem cells (MSCs) have been extensively investigated as promising vehicles for cell-based drug delivery systems (DDS) due to their inherent tumor homing capability, driven by chemoattractant gradients emitted from the chronic inflammatory tumor microenvironment (TME). Various MSC-based therapies have been developed, including genetically engineered MSCs expressing antitumoral cytokines or suicide genes, drug-loaded MSCs, and oncolytic virus-loaded MSC-designed to evade circulating neutralizing antibodies. While some of these approaches have advanced to early-phase clinical trials, critical challenges have emerged. These include the risk of MSCs differentiating into cancer-associated fibroblast (CAF)-like cells that promote tumor progression within the TME, and the concern that the intrinsic immunosuppressive property of MSCs may foster tumor immune evasion. This review summarizes the paradigms of MSC-based anticancer research conducted globally, and discusses the ongoing challenges and for their clinical translation.