Extracellular vesicles (EVs) are nanoscale substances produced by most cells, which were not fully understood in the early years. However, with the development of advanced techniques, researchers have discovered that EVs play an essential role in information exchange and signal transduction between cells. Nowadays, EVs are being used, modified, and developed as a natural drug carrier in various medical fields because of their high biocompatibility and natural affinity with the source body. Many studies have shown that multiple sources of EVs have been modified and utilized in cancer therapy to improve patients' treatment windows and effectively prolong patient survival. In this paper, we review the advances in the treatment of cancer based on EVs. We summarize the types of EVs loading therapy, the modes of drug loading and the latest therapeutic applications of multiple modes combined with EVs in cancer treatment. We conclude with a discussion of the current status, challenges, and prospects of EVs as a tool for tumor therapy.
