Table 5 Engineered EVs with stimuli-responsive properties for precision cancer immunotherapy

Exosomes expressing a mutant viral glycoprotein (VSV-G)

Not specified

Enhance tumor immunogenicity via pathogen-associated molecular patterns (PAMPs)

pH-dependent delivery of viral antigen to cancer cells, triggering an immune response through recognition of PAMPs

[169]

Hybrid nanoparticles (HNPs) combining EVs and thermosensitive liposomes

Peritoneal carcinomatosis (MPC)

Enhance drug penetration and release via hyperthermic intraperitoneal chemotherapy (HIPEC)

Thermosensitive liposomes release therapeutic payload when exposed to hyperthermic conditions, improving drug penetration

[170]

Hybrid therapeutic nanovesicles (hGLVs) combining GE-Exosomes and thermosensitive liposomes

Not specified

Improve macrophage-mediated phagocytosis and drug release via photothermal stimuli

Overexpression of CD47 on hGLVs inhibits CD47 signaling, improving macrophage-mediated phagocytosis; photothermal stimulus triggers drug release

[109]

Genetically engineered exosome nanocatalysts (Mn^@Bi2Se3^@RGE-Exos)

Glioblastoma (GBM)

Enhance BBB penetration and oxidative stress-induced cell damage

NIR-II light triggers enzyme-like activities in Mn@Bi2Se3@RGE-Exos, improving GBM cell damage and oxidative stress response

[171]

Adipose-derived stem cell exosomes encapsulated within Ag^@BSA nanoflowers

Diabetic wound healing

Controlled release for bacterial elimination, tissue regeneration, and neovascularization

Exosomes release therapeutic agents targeting oxidative wound microenvironment, improving tissue regeneration and healing

[172]

B-cell-derived EVs loaded with zinc oxide nanocrystals (ZnO NCs) and anti-CD20 antibodies

Lymphoma

Target and enhance cytotoxicity against CD20⁺ cancer cells via ultrasound activation

Zinc oxide nanocrystals and anti-CD20 antibodies delivered by EVs are activated by high-energy ultrasound, enhancing cytotoxicity

[173]