Exosome-Based Delivery and Functional Regulation of Bioactive Components from Traditional Chinese Medicine for Lung Cancer Treatment

Abstract

Lung cancer remains one of the leading causes of cancer‑related mortality worldwide. Despite continuous advances in antitumor therapy, challenges such as drug resistance, toxic side effects, and insufficient tumor‑targeted accumulation of drugs still persist. Exosomes (EXOs), as natural nanovesicles with a diameter of 30–150 nm, serve not only as key mediators of intercellular communication but also as ideal drug delivery vehicles, playing critical roles in tumor proliferation, epithelial–mesenchymal transition (EMT), drug resistance, and remodeling of the immune microenvironment. In recent years, nanotechnology engineering strategies—including surface modification of exosomes, construction of hybrid exosomes, and engineering modifications—have significantly enhanced the utilization of bioactive components from traditional Chinese medicine (TCM). This article systematically reviews two core pathways through which TCM intervenes in lung cancer via exosomes: functional regulation and nano‑delivery. It also incorporates the direct antitumor effects of plant‑derived exosome‑like vesicles (PELVs), thereby establishing a bidirectional interaction framework between exosomes and TCM. This framework provides new directions for the development of TCM‑based nanomedicines for lung cancer and their clinical translation.