植物源性细胞外囊泡（PDE）因其低细胞毒性、低免疫原性、高产量和潜在的抗肿瘤功效而有望成为癌症治疗的一种引人注目的替代品。尽管 PDE 具有显着优势，但 PDE 作为有前途的抗肿瘤方法的可靠证据仍然不系统且不足。 PDEs的临床应用和大规模工业化生产仍存在一些挑战。通过系统评价和荟萃分析，为PDEs在癌症治疗中的临床应用提供科学、系统、可靠的临床前证据。相关文献截至2024年3月，涵盖Web of Science、Cochrane Library、Embase、PubMed、CNKI、万方数据、中国科技期刊数据库等数据库。 SYRCLE 的偏倚风险工具用于评估动物研究的方法学质量。总体效果分析和亚组分析使用RevMan 5.4和Stata 12.0。分析共纳入38篇文章，其中29篇体内研究和9篇体外研究。荟萃分析表明，PDEs用作治疗剂时可显着降低癌细胞活性并诱导细胞凋亡，减少肿瘤体积和肿瘤重量，并通过联合治疗表现出协同抗癌作用。此外，与游离药物或商业脂质体药物相比，PDE 药物对肿瘤体积具有更强的抑制作用。其治疗作用与调节肿瘤细胞生物学行为、重塑肿瘤微环境密切相关。安全性与PDEs的给药途径有关，目前口服给药是首选，直到对其他方法的安全性进行更深入的研究。荟萃分析显示，PDEs在癌症治疗的临床前研究中具有系统可靠的临床前证据，其有效性和一定的安全性可以支持PDEs在癌症治疗中的临床应用。当然，大规模工业化生产还需要进一步研究，以满足临床应用的需求。版权所有 © 2024 Elsevier GmbH。版权所有。

Plant-derived extracellular vesicles (PDEs) are expected to be a compelling alternative for cancer treatment due to their low cytotoxicity, low immunogenicity, high yield, and potential anti-tumor efficacy. Despite the significant advantages of PDEs, the reliable evidence for PDEs as promising anti-tumor approach remains unsystematic and insufficient. Some challenges remain for the clinical application and large-scale industrial production of PDEs.Through systematic evaluation and meta-analysis, the objective was to provide scientific, systematic and reliable preclinical evidence to support the clinical use of PDEs in cancer therapy.The search for relevant literature, conducted up to March 2024, encompassed various databases including Web of Science, the Cochrane Library, Embase, PubMed, CNKI, Wanfang Data, and the China Science and Technology Journal Database. The SYRCLE´s risk of bias tool was used to assess the methodological quality of the animal studies. For overall effect analysis and subgroup analysis, RevMan 5.4 and Stata 12.0 were utilized.The analysis incorporated a total of 38 articles, comprising 29 in vivo studies and 9 in vitro studies. Meta-analysis indicated that PDEs significantly reduced cancer cell activity and induced apoptosis, reduced tumor volume and tumor weight when used as therapeutic agents, as well as exhibited synergistic anti-cancer via combination therapy. Additionally, PDEs-drugs exerted stronger inhibition of tumor volume compared to the free drug or commercial liposome-drugs. Their therapeutic effects were closely related to regulating tumor cell biological behavior and remodeling the tumor microenvironment. The safety was associated with administration route of PDEs, oral administration was currently preferred until more in-depth studies on the safety of other methods are conducted.The meta-analysis revealed that PDEs have systematic and reliable preclinical evidence in preclinical studies of cancer therapy, and their efficacy and certain safety could support the clinical application of PDEs in cancer therapy. Of course, further researches are required for large-scale industrial production to meet the needs of clinical applications.Copyright © 2024 Elsevier GmbH. All rights reserved.