Cited by 3Radiation Therapy and DosimetryExtracellular vesicles in diseaseNanoplatforms for cancer theranostics

Exosome-loaded nanoradiosensitizers in radiotherapy for preventing post-irradiation tumor recurrence: Mechanisms, preclinical evidence, and translational challenges

Open access
Uti, Daniel Ejim, Egbung, Josephine E., Anthony, Bassey Omeh, Omari, Ogar Rose, Omang, Wilson Achu, Aggad, Waheeb Sami, Almohaimeed, Hailah M., Bainsal, Neeraj +3 more·2026·Discover Nano

Abstract

Radiotherapy remains a cornerstone in cancer treatment, yet its therapeutic efficacy is often limited by radioresistance, tumor heterogeneity, and recurrence post-irradiation. Nanotechnology has emerged as a promising avenue to enhance radiosensitization, improve tumor selectivity, and reduce off-target toxicity. Among these, exosome-loaded nanoradiosensitizers represent an innovative strategy, leveraging the natural biocompatibility, tumor-homing ability, and immunomodulatory properties of exosomes to deliver radiosensitizing agents with precision. This review examines the design principles, fabrication strategies, and functional mechanisms of exosome-based nanoradiosensitizers, highlighting how they enhance DNA damage, modulate the tumor microenvironment, and overcome intrinsic and acquired radioresistance. We discuss the molecular mechanisms underlying radiosensitization, including reactive oxygen species (ROS) amplification, cell-cycle modulation, hypoxia alleviation, and immune system engagement. Furthermore, we explore in vitro and in vivo preclinical evidence demonstrating the efficacy of these systems in reducing tumor recurrence post-irradiation. Challenges such as scalable exosome production, cargo loading efficiency, targeted delivery, and regulatory considerations are critically evaluated. Finally, the review outlines translational perspectives, potential combinatorial therapies, and key considerations for clinical trial design. By integrating insights from nanomedicine, radiobiology, and exosome biology, this review aims to provide a comprehensive framework for the development of next-generation exosome-based nanoradiosensitizers, ultimately enhancing radiotherapy outcomes and minimizing tumor relapse in resistant cancers.

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Crossref · 10.1186/s11671-026-04681-9

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  • Exosome-based and exosome-mimicking systems have attracted increasing interest because of intrinsic biocompatibility, tumor-homing potential, and ability to facilitate intracellular transport of functional cargo.

    “In particular, exosome-based and exosome-mimicking systems have attracted increasing interest because of their intrinsic biocompatibility, tumor-homing potential, and ability to facilitate intracellular transport of functional cargo [106,107,108].”

    From Nanoparticle-Mediated Radiosensitization in Breast Cancer: A Systematic Review of Preclinical Evidence and Translational Challenges (2026) · cites this paper as [108]

    The Introduction and ‘Exosome biology and therapeutic potential’ sections describe exosomes as biocompatible delivery vehicles with tumor-homing potential and effective cellular uptake of cargo. The Introduction distinguishes exosome-mimetic vesicles from the exosomes on which the review focuses; the cited passages do not establish that mimetic systems share all these properties. Page numbers are unavailable in our copy. (LLM, conf=0.85)

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Research works printed but not linked: 3

  1. [83]Zhang M, Hu S, Liu L, Dang P, Liu Y, Sun Z, Qiao B, Wang C. Engineered exosomes from different sources for cancer-targeted therapy. Signal Transduct Target Ther. 2023;8:1–20. 10.1038/s41392-023-01382-y. 36922504 PMC10017761 · DOI
  2. [122]Biswal P, Vijay GV, Krouse G, Mai PMQ, Lakshmisha BM, Shahbaz SK, Taba MY, Sabbagh A, Cheung LWT, Mackeyev Y, Koushki K, Krishnan S. Tumor radiosensitization with gold nanoparticles: evolving strategies to improve tumoral gold uptake and catalyze future clinical translation. ACS Nano Med. 2026. 10.1021/acsnanomed.5c00110. 41743230 PMC12931844 · DOI
  3. [126]Yang Y, Ren S, Huang W, Dong J, Guo J, Zhao J, Zhang Y. Camptothecin delivery via tumor-derived exosome for radiosensitization by cell cycle regulation on patient-derived xenograft mice. Front Bioeng Biotechnol. 2022. 10.3389/fbioe.2022.876641. 35497339 PMC9039187 · DOI

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Authors
Uti, D. E., Egbung, J. E., Anthony, B. O., Omari, O. R., Omang, W. A., Aggad, W. S., Almohaimeed, H. M., Bainsal, N., Shukla, S. K., Ealla, K. K. R., & Alum, E. U.
Affiliations
  • Kampala International University (UG)
  • University of Calabar (NG)
  • University of Jeddah (SA)
  • Princess Nourah bint Abdulrahman University (SA)
  • Chandigarh University (IN)
  • Sharda University (IN)
  • Malla Reddy Vishwavidyapeeth (IN)
Corresponding author
Uti, Daniel Ejim
Venue
Discover Nano
Published
2026-05-27
Volume
21
Issue
1
ISSN
2731-9229 (ISSN-L)
OpenAlex
W7162496944
Cited by
3
References
175
Citations by year
2026: 3
FWCI
3.86
Type
journal article
Language
en
Open access
Locations
  • Discover Nano (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Princess Nourah Bint Abdulrahman University (PNURSP2026R213)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Radiation Therapy and Dosimetry
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Extracellular vesicles in disease
  • Physical Sciences › Engineering › Biomedical Engineering › Nanoplatforms for cancer theranostics
Keywords
radiosensitization, radioresistance (biology), tumor recurrence, exosomes, nanomedicine, reactive oxygen species, tumor hypoxia, tumor microenvironment, cell cycle modulation, targeted delivery, exosome production, radiotherapy

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