Stem Cell-Derived Extracellular Vesicles in Bladder Cancer: Diagnostic Potential and Therapeutic Challenges

With population aging, the high prevalence and recurrence rate of bladder cancer increasingly threaten the health of older adults. Although surgery is effective for most early-stage bladder cancer, frequent recurrence and the risk of metastasis compromise patients' quality of life, while subsequent radical surgery can cause a substantial further decline. Advances in nanobiomedicine have highlighted nanoscale vesicles as potential tools for the early diagnosis and treatment of bladder cancer, particularly as stem cell-based and stem cell-derived vesicle-based nanomedicine approaches mature. Studies suggest that extracellular vesicles derived from mesenchymal stem cells and bladder cancer stem cells, enriched in specific bioactive molecules and characterized by strong targeting capabilities and low immunogenicity, may support early diagnosis and cell-free targeted therapy for bladder cancer, potentially reducing its high recurrence rate and risk of metastasis. This review therefore summarizes preclinical studies of extracellular vesicles derived from malignant and nonmalignant stem cells in bladder cancer and discusses their diagnostic and therapeutic potential to expand nanomedicine approaches to bladder cancer diagnosis and treatment.