Therapeutic application of mesenchymal stem cells-derived extracellular vesicles in colorectal cancer

Colorectal cancer (CRC) is the third most common cancer and the leading cause of cancer death globally. Resistance to therapy is a challenge for CRC treatment. Mesenchymal stem cells (MSCs) have become one of the furthermost effective approaches for tumor treatment due to their specific feature; however, their therapeutic function is controversial. Recently, extracellular vesicles (EVs) derived from MSCs (MSCs-EVs) have attracted extensive research attention due to their promising role in CRC treatment. EVs are cell-derived vesicles that transfer different biomolecules between cells, contributing to intracellular communication. MSCs-EVs can suppress CRC by delivering therapeutic agents to tumor cells. Several studies indicate that MSCs-EVs can serve as a drug delivery system for the treatment of different cancers. Various methods are used to modify (engineer) MSCs-EVs for loading therapeutic agents. Modified MSCs-EVs have improved specificity, targeting ability, and immunogenicity compared to synthetic carriers. Furthermore, CRC-EVs participate in regulating different cells, such as immune cells, fibroblasts, and endothelial cells, promoting tumorigenesis. MSCs-EVs-based therapy indicates a high potential in the treatment of cancer; however, the majority of studies have been conducted in the pre-clinical, and their clinical applications need further scrutiny. In this review, we describe the biogenesis of EVs, focusing on the effect of MSCs-EVs on CRC cells and CRC-derived EVs on other cells. Furthermore, MSCs-EVs as a drug delivery system for cancers is also reviewed, and perspectives regarding the therapeutic application of MSCs-EVs are discussed.