Table 3.

Exosome modification strategies to improve exosome tumor targeting efficiency.

Targeting Type	Examples	Target	Effect	Exosome Source	Delivery Molecule	Reference
Passive	CD47 surface decoration	SIRPα	Increased exosome circulation time	Mouse embryonic fibroblasts (MEFs)	mRNA	[130]
	Surface PEGylation	N/A	Reduced exosome clearance Enhanced tumor penetration	4T1 murine breast cancer cells	N/A	[131]
	iRGD peptide fusion with Lamp2b	N/A	Inhibited tumor growth without overt toxicity	Mouse immature dendritic cells	Doxorubicin	[132]
Active	IL3-Lamp2b expressing exosome production	IL3 receptors	Increased intratumoral accumulation	HEK293T cells	Imatinib, BCR-ABL siRNA	[133]
	Exosome azide integration, DBCO-PEG4-biotin avidin conjugation	Biotin receptors, glycan biosynthesis process	Higher uptake levels	B16F10 cells	Streptavidin-HRP	[134]
	Neuraminidase	Terminal sialic acid residues from glycoproteins	Rapid accumulation of EVs in the liver	MLP29 cells	N/A	[135]
	3-(diethylamino) propyl-amine (DEAP)	N/A	pH sensitive uptake	RAW 264.7 cells	N/A	[136]
	αCD3 and αHER2 antibodies’ surface expression	CD3, HER2 receptors	Increased T cell activation	Expi293 cells	N/A	[137]
	anti-SSTR2 mAb	Somatostatin receptor 2 (SSTR2)	High toxicity of cancer cells	HEK 293 cells	Romidepsin	[138]
	DSPE-PEG biotin and avidin conjugation	Biotin receptors	Increased stability and encapsulation efficiency	HUVECs	N/A	[139]
	Diacyllipid–aptamer(sgc8) PEG conjugation	PTK7	Increased cellular uptake	ImDC cells	Doxorubicin	[140]