(A) Outline of the sandwich complex between TiO2-coated Fe3O4 beads (Fe3O4@TiO2), exosomes and SERS-encoded nanoparticles (SEPs) comprising a gold-silver core-shell nucleus functionalized with 4-mercaptobenzoic acid (MBA) as the SERS code and further conjugated with an anti-PD-L1 antibody. (B,C) SEM images of Fe3O4@TiO2 + A549 exosome, and Fe3O4@TiO2 + A549 exosome + SEPs, respectively.(D) Scatter plots of the log SERS intensity (MBA band at ca. 1074 cm−1) in the serum samples from the controls and the early-stage (stage I/II) and advanced (stage III/IV) patients diagnosed with non-small-cell lung carcinoma (NSCLC). Adapted with permission from [95]. Copyright 2020, Elsevier.