Accurately assaying tumor-derived circulating extracellular
vesicles
(EVs) is fundamental in noninvasive cancer diagnosis and therapeutic
monitoring but limited by challenges in efficient EV isolation and
profiling. Here, we report a bioinspired buoyancy-driven metal–organic
framework (MOF) corona that leverages on-bubble coordination and dual-encoded
surface-enhanced Raman scattering (SERS) nanotags to streamline rapid
isolation and ultrasensitive profiling of plasma EVs in a single assay
for cancer diagnostics. This integrated bubble-MOF-SERS EV assay (IBMsv)
allows barnacle-like high-density adhesion of MOFs on a self-floating
bubble surface to enable fast isolation (2 min, near 90% capture efficiency)
of tumor EVs via enhanced EV-MOF binding. Also, IBMsv harnesses four-plexed
SERS nanotags to profile the captured EV surface protein markers at
a single-particle level. Such a sensitive assay allows multiplexed
profiling of EVs across five cancer types, revealing heterogeneous
EV surface expression patterns. Furthermore, the IBMsv assay enables
cancer diagnosis in a pilot clinical cohort (n =
55) with accuracies >95%, improves discrimination between cancer
and
noncancer patients via an algorithm, and monitors the surgical treatment
response from hepatocellular carcinoma patients. This assay provides
a fast, sensitive, streamlined, multiplexed, and portable blood test
tool to enable cancer diagnosis and response monitoring in clinical
settings.