胶质母细胞瘤（GBM）是一种具有侵袭性的癌症类型，导致了大量人口的死亡。传统方法未能为GBM的病情提供解决方案。对肿瘤微环境（TME）的广泛研究表明，TME细胞外囊泡（EVs）在癌症的发展和进展中起着重要作用。EVs被分为微囊泡、凋亡小体和外泌体。外泌体是癌症研究中最受关注的领域。GBM细胞衍生的外泌体参与了多种癌症进程事件，如免疫抑制、血管生成、前转移微环境形成（PMN）、细胞外基质（ECM）、上皮-间质转化（EMT）、转移、肿瘤干细胞发展以及治疗和药物耐药。GBM外泌体还携带着与胶质母细胞瘤相关状态的特征。基于外泌体的GBM检查是新一代液体活检的一部分，也解决了GBM早期诊断的局限性。传统治疗方法无法穿越血脑屏障（BBB）。外泌体在GBM治疗中是一种改变游戏规则的因素，并且正在成为一个有效、高效和特异性治疗的潜在平台。在本综述中，我们探讨了外泌体-GBM的相互联系、外泌体对GBM生物标志物的临床影响、GBM中外泌体的治疗特征、基于外泌体的研究挑战以及GBM的未来方向。因此，GBM衍生的外泌体提供了独特的治疗机会，目前正处于临床前和临床测试阶段。

Glioblastoma (GBM) is an aggressive type of cancer that has led to the death of a large population. The traditional approach fails to develop a solution for GBM's suffering life. Extensive research into tumor microenvironments (TME) indicates that TME extracellular vesicles (EVs) play a vital role in cancer development and progression. EVs are classified into microvacuoles, apoptotic bodies, and exosomes. Exosomes are the most highlighted domains in cancer research. GBM cell-derived exosomes participate in multiple cancer progression events such as immune suppression, angiogenesis, premetastatic niche formation (PMN), ECM (extracellular matrix), EMT (epithelial-to-mesenchymal transition), metastasis, cancer stem cell development and therapeutic and drug resistance. GBM exosomes also carry the signature of a glioblastoma-related status. The exosome-based GBM examination is part of the new generation of liquid biopsy. It also solved early diagnostic limitations in GBM. Traditional therapeutic approaches do not cross the blood-brain barrier (BBB). Exosomes are a game changer in GBM treatment and it is emerging as a potential platform for effective, efficient, and specific therapeutic development. In this review, we have explored the exosome-GBM interlink, the clinical impact of exosomes on GBM biomarkers, the therapeutics signature of exosomes in GBM, exosome-based research challenges, and future directions in GBM. Therefore, the GBM-derived exosomes offer unique therapeutic opportunities, which are currently under preclinical and clinical testing.