The potential of exosome-based gene therapy to eradicate glioblastoma cells

New treatment methods are urgently needed for glioblastoma (GBM), the most common malignant primary brain tumor in adults, that currently lacks any curative treatment. Targeted therapeutic approaches have shown promising results already, but common drug delivery vehicles come with efficacy issues and are restricted by their safety and toxicity profiles. Exosomes, cell-produced nanosized vesicles, have emerged as a new potential carrier for gene therapies in cancer treatment due to their natural material transport properties, biocompatibility, and specificity in transporting cargo to the target cells. These extracellular vesicles have the additional advantage of being able to cross the blood-brain-barrier (BBB), which makes them especially valuable for brain malignancies, such as glioblastomas. So far, gene therapy approaches in exosomes have focused on RNA in cancer treatment, but research findings are limited with plasmid-based gene therapies using exosomes. The main concern has been whether the increased plasmid size would decrease the transfection efficiency of the plasmid into the exosomes. This study aimed at setting-up exosomes as plasmid-based gene therapy nanocarriers. To achieve this, different plasmid-based gene therapies were tested, including the targeting of common aberrations of GBM cells to impair proliferation and the use of cytotoxins to induce apoptosis in the target cells. The plasmids were transfected into exosomes and subsequently inoculated into patient-derived glioblastoma cells with the aim of decreasing the number of glioblastoma cells. The findings of this study demonstrate a successful set-up of an exosome-based gene therapy in patient-derived glioblastoma cells by using engineered HEK293FT cell derived exosomes consisting of a plasmid-based combination gene therapy encoding the cytotoxins Granzyme B and Diphtheria toxin fragment A