Fig. 6. Necroptosis induction using exosomes.

Engineered exosomes with TFNα on their surface, carrying two vectors of the CRISPR/Cas system capable of inhibiting cIAPs and caspase 8. In this approach, the exosome-TNFα ligand provokes TNFR signaling pathways, which can activate the cIAPs, propelling the cell toward survival. CRISPR/Cas9-mediated inhibition of cIAPs alongside active caspase 8 results in apoptosis of cancer cells. Moreover, dual inhibiting of cIAPs and caspase 8 alongside TNFR signaling lead to necroptosis. The advantage of necroptosis over apoptosis is that the former also provokes T-cells to eliminate the remaining cancer cells.