Acellular approaches for regenerative medicine: on the verge of clinical trials with extracellular membrane vesicles?

Table 1 Summary of current clinical trials with extracellular vesicles and their applications

EV source	Application	Proposed mechanism	Clinical phase	Status	Reference
Dendritic cell-derived exosomes	Metastatic melanoma	Immunisation with autologous exosomes pulsed with MAGE 3	Phase I	Completed showing safety and feasibility	[76]
Ascite-derived exosomes	Colorectal cancer immunotherapy	Immunisation with ascite-derived exosomes and GM-CSF	Phase I	Completed showing safety and feasibility	[77]
Dendritic cell-derived exosomes	Non-small cell lung cancer (NSCLC)	Immunisation with autologous exosomes loaded with MAGE antigens	Phase I	Completed showing safety and feasibility	[80]
MSC-derived exosomes	Graft-versus host disease (GvHD)	Donor-derived exosomes to recapitulate the immunomodulatory properties of MSCs	Individual patient	Symptoms improved and stabilized for several months. Patient died of pneumonia after 7 months	[78]
Dendritic cell-derived exosomes	Large-scale interferon-gamma vaccines	Immunisation with exosomes loaded with tumour antigens	Phase II	Ongoing	[80]

EV extracellular vesicle, GM-CSF granulocyte–macrophage colony-stimulating factor, MAGE melanoma-associated antigen, MSC mesenchymal stem cell

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