Exosomes have emerged as pivotal players in precision oncology, offering innovative solutions to longstanding challenges such as metastasis, therapeutic resistance, and immune evasion. These nanoscale extracellular vesicles facilitate intercellular communication by transferring bioactive molecules that mirror the biological state of their parent cells, positioning them as transformative tools for cancer diagnostics and therapeutics. Recent advancements in exosome engineering, artificial intelligence (AI)-driven analytics, and isolation technologies are breaking barriers in scalability, reproducibility, and clinical application. Bioengineered exosomes are being leveraged for CRISPR-Cas9 delivery, while AI models are enhancing biomarker discovery and liquid biopsy accuracy. Despite these advancements, key obstacles such as heterogeneity in exosome populations and the lack of standardized isolation protocols persist. This review synthesizes pioneering research on exosome biology, molecular engineering, and clinical translation, emphasizing their dual roles as both mediators of tumor progression and tools for intervention. It also explores emerging areas, including microbiome–exosome interactions and the integration of machine learning in exosome-based precision medicine. By bridging innovation with translational strategies, this work charts a forward-looking path for integrating exosomes into next-generation cancer care, setting it apart as a comprehensive guide to overcoming clinical and technological hurdles in this rapidly evolving field.
外泌体已成为精准肿瘤学的关键参与者，为转移、治疗抵抗和免疫逃逸等长期挑战提供了创新解决方案。这些纳米级细胞外囊泡通过传递反映亲本细胞生物状态的活性分子促进细胞间通讯，使其成为癌症诊断和治疗的变革性工具。近年来在外泌体工程、人工智能驱动分析和分离技术方面的突破，正推动其规模化应用、可重复性和临床转化取得进展。生物工程改造的外泌体正被用于CRISPR-Cas9递送，而人工智能模型则提升了生物标志物发现和液体活检的准确性。尽管取得这些进展，外泌体群体的异质性和标准化分离方案的缺失等关键障碍仍然存在。本综述系统整合了外泌体生物学、分子工程和临床转化方面的前沿研究，强调其既作为肿瘤进展介质又作为干预工具的双重作用，并探讨了微生物组-外泌体相互作用、机器学习在外泌体精准医学中的应用等新兴领域。通过将创新与转化策略相结合，本研究为外泌体融入下一代癌症诊疗绘制了前瞻性路线图，为克服这一快速发展领域的临床与技术障碍提供了全面指导。
Exosomes in Precision Oncology and Beyond: From Bench to Bedside in Diagnostics and Therapeutics
肿瘤(癌症)患者之家