While immunotherapy has brought about groundbreaking changes in cancer treatment methods, a considerable number of patients show resistance or lack of response to it. Extracellular vesicles (EVs) comprising exosomes and microvesicles have become factors in the advancement of cancer treatment and modulation of the immune system. Three databases (Scopus, Google Scholar, and PubMed) were searched for published articles on EVs concerning their role in countering cancer immunotherapy resistance. The in vitro and in vivo original studies written in English from January 2013 to December 2023 were included in this study. Twenty affiliated articles with complete abstracts were included in this study. Recent research has shed light on the functions of EVs in the interactions between cancer and the immune system as well as in resistance to immunotherapy treatments. EVs released by tumors that are resistant to treatment contain unique molecular markers such as proteins that suppress the immune systems response and substances that affect both the environment around the tumor and the body overall immune reactions. Scientists have pinpointed biomarkers found in EVs that can indicate how a patient may respond to immunotherapy for different types of cancer. There is a growing body of evidence indicating that EVs play a role in transferring molecules, like Programmed Cell Death Ligand 1 (PD L1) and other proteins involved in regulating the response during therapy resistance scenarios. New and innovative ways to address EVs are proving to be effective options for treatment in the field of medicine and healthcare industry. This analysis underscores the role of EVs as potential biomarkers and targets for treatment in cancers that are resistant to immunotherapy interventions. Liquid biopsies based on EVs provide an invasive method for tracking treatment response and the development of resistance.

Keywords