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Yet their dual nature as suppressors and potential therapeutics is not fully integrated into current cancer immunotherapy frameworks. This review details molecular mechanisms of TDE-mediated suppression and resistance and highlights engineering approaches to exploit or counter exosome biology.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-avatar-principle-exosomal-dynamics-guiding-tumor-adaptation-and-next-generation-therapeutic-strategies/355086/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-avatar-principle-exosomal-dynamics-guiding-tumor-adaptation-and-next-generation-therapeutic-strategies/355086.png","ImageObject",300,407,{"name":42,"@type":43},"Liam","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-01","2026-09-22",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",17,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What roles do tumor-derived exosomes (TDEs) play in cancer progression?","Question",{"text":63,"@type":64},"TDEs facilitate immune evasion, remodel the tumor microenvironment, and help create premetastatic niches, collectively intensifying tumor aggressiveness and undermining therapeutic efficacy.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why are TDEs both a challenge and an opportunity for therapy?",{"text":68,"@type":64},"TDEs act as suppressive agents that promote therapeutic resistance, but the same biology can be leveraged through engineering strategies to counteract suppression or deliver therapeutic functions.",{"name":70,"@type":61,"acceptedAnswer":71},"How can CAR T cell-derived exosomes be used in immunotherapy?",{"text":72,"@type":64},"CAR T-derived exosomes preserve antigen specificity and cytotoxic components while lacking replicative capacity and avoiding risks associated with uncontrolled proliferation or cytokine release.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},355086,1790176903,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Baena etal. Journal of Nanobiotechnology (2026) 24:159  \n[https://doi.org/10.1186/s12951-026-04089-8](https://doi.org/10.1186/s12951-026-04089-8)  \nJournal of Nanobiotechnology  \nREVIEW Open Access  \nThe avatar principle: exosomal dynamics guiding tumor adaptation and nextgeneration therapeutic strategies  \nJuan C. Baena 1,2,14*, Sergio Camilo Cabrera-Salcedo2,3*, Yesenia Carrera Suárez4,5, Juan M. Biancha-Vasco6, Lady J. Rios-Serna2,6, M. Daniela García-Mantilla3, Manuela Estrada-Schweineberg3,7,  \nJuan Sebastian Victoria Hincapie 1,2, Alejandro Toro-Pedroza2,3, Juan Esteban Garcia-Robledo2,8, Carlos A. Cañas2,6,9, Joshua Ortiz-Guzman2,10,11 and Alexandre Loukanov2,12,13  \nAbstract  \nExosomes are nanoscale extracellular vesicles that transfer proteins, nucleic acids, and lipids, reflecting the state of their parent cells. A persistent scientific challenge is that tumor-derived exosomes (TDEs) facilitate immune evasion, remodel the tumor microenvironment, and create premetastatic niches, intensifying tumor aggressiveness and undermining therapeutic efficacy, ultimately narrowing treatment options to palliative strategies in advanced settings. Yet their dual roles as suppressive agents and potential therapeutic tools remain poorly integrated within current cancer immunotherapy frameworks. This review examines the molecular mechanisms underlying TDE-mediated immune suppression and therapeutic resistance, while also highlighting engineering strategies to exploit or counteract exosome biology. Exosomes derived from chimeric antigen receptor (CAR) T cells preserve antigen specificity and cytotoxic components without the risks of uncontrolled proliferation or cytokine release, offering a safer class of cell free immunotherapies. Advances in genetic engineering, hybrid vesicle design, and nanotechnology have extended exosome applications to the delivery of CRISPR/Cas systems, chemotherapeutic agents, immunoregulatory RNAs, and vaccines, with liposome or nanoparticle integration enhancing targeting and efficacy. Remaining obstacles include the lack of standardized protocols, scalability issues in production, and unresolved regulatory frameworks. Drawing on The Art of War, exosomes can be envisioned as avatars of strategy, discreet messengers capable of undermining host defenses while simultaneously carrying the potential to redirect immunity against the tumor. By embodying both deception and counterattack, they illustrate the capacity to penetrate hidden barriers and redefine the therapeutic battlefield, opening new horizons for precision cancer immunotherapy.  \n*Correspondence:  \nJuan C. Baena [Juan.baena@fvl.org.co](Juan.baena@fvl.org.co)[ ](Juan.baena@fvl.org.co)Sergio Camilo Cabrera-Salcedo [sergio.cabrera.sa@fvl.org.co](sergio.cabrera.sa@fvl.org.co)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.)  \nBaena et al. Journal of Nanobiotechnology (2026) 24:159 Page 2 of 29  \nKeywords Exosomes, Tumor-derived exosomes (TDEs), Extracellular vesicles (EVs), Chimer","cbCaibE4DO2lRvHL","https://ap.wps.com/l/cbCaibE4DO2lRvHL","pdf",5850249,29,"English","# Abstract\n# Introduction\n## Exosomes as mediators of intercellular communication\n## TDEs in immune evasion and microenvironment remodeling\n## CAR T-derived exosomes and potential therapeutic roles","[{\"question\":\"What roles do tumor-derived exosomes (TDEs) play in cancer progression?\",\"answer\":\"TDEs facilitate immune evasion, remodel the tumor microenvironment, and help create premetastatic niches, collectively intensifying tumor aggressiveness and undermining therapeutic efficacy.\"},{\"question\":\"Why are TDEs both a challenge and an opportunity for therapy?\",\"answer\":\"TDEs act as suppressive agents that promote therapeutic resistance, but the same biology can be leveraged through engineering strategies to counteract suppression or deliver therapeutic functions.\"},{\"question\":\"How can CAR T cell-derived exosomes be used in immunotherapy?\",\"answer\":\"CAR T-derived exosomes preserve antigen specificity and cytotoxic components while lacking replicative capacity and avoiding risks associated with uncontrolled proliferation or cytokine release.\"}]","The avatar principle: exosomal dynamics guiding tumor adaptation and next-generation therapeutic strategies | PDF",1790115833,73]