Clinical Application of Small Extracellular Vesicles in Gynecologic Malignancy Treatments

SIMPLE SUMMARY: Common gynecologic malignancies include ovarian, cervical, and endometrial cancer. Endometriosis is characterized by distant metastasis and is associated with gynecologic tumors. Most gynecologic malignancies are diagnosed in the middle and late stages of cancer, which complicates treatment; therefore, early diagnosis and therapy are beneficial to patient prognosis. Small extracellular vesicles (sEVs) have rich content, stable existence, and low antigenicity, which can be used for early diagnosis and precision treatment. However, current sEVs detection methods are difficult to popularize, and the contents of sEVs are complex and thus unsuitable to meet the requirements of clinical detection. This highlights the need to find more accurate and targeted molecules with diagnostic value. Our review aims to summarize the extraction and identification of sEVs and their application in the early detection and targeted therapy of gynecologic malignancies in recent years. ABSTRACT: Small extracellular vesicles (sEVs) are the key mediators of intercellular communication. They have the potential for clinical use as diagnostic or therapeutic biomarkers and have been explored as vectors for drug delivery. Identification of reliable and noninvasive biomarkers, such as sEVs, is important for early diagnosis and precise treatment of gynecologic diseases to improve patient prognosis. Previous reviews have summarized routine sEVs isolation and identification methods; however, novel and unconventional methods have not been comprehensively described. This review summarizes a convenient method of isolating sEVs from body fluids and liquid biopsy-related sEV markers for early, minimally invasive diagnosis of gynecologic diseases. In addition, the characteristics of sEVs as drug carriers and in precision treatment and drug resistance are introduced, providing a strong foundation for identifying novel and potential therapeutic targets for sEV therapy. We propose potential directions for further research on the applications of sEVs in the diagnosis and treatment of gynecologic diseases.