Extracellular vesicles as liquid biopsy tools for personalized therapeutic goals in glioblastoma

Although there has been a considerable increase in the understanding of glioblastoma and investigations into the therapeutic utility of several novel putative active compounds, the prognosis of glioblastoma patients remains dismal. This paradox makes glioblastoma a unique disease, in which the availability of key molecular and biological insight does not translate into therapeutic discovery or improved outcomes. Much of the challenge in glioblastoma treatment is attributable to a dearth of tools capable of accurately selecting patients who might benefit from current standard-of-care or targeted therapies. Moreover, the lack of reliable circulating biomarkers also delays treatment initiation and hampers evaluation of the therapeutic response. However, the emergence of a personalized medicine paradigm using extracellular vesicles has the potential to revolutionize cancer treatment, bringing renewed hope for patients with glioblastoma. In this review, we provide a brief overview of the current standard-of-care therapies, immunotherapeutic approaches and their clinical limitations. We then introduce the need for a personalized model and discuss the conceptual underpinnings of how extracellular vesicle cargo as a superior liquid biopsy tool can be used for a new personalized therapeutic approach in glioblastoma.