“…Immune system is the most powerful barrier to cancer metastasis. Massive studies have demonstrated that, within the tumor local inflammatory microenvironment, CDEs can transport proteins similar to parent tumor cells, proinflammatory chemokines, and cytokines, such as IL-35, IL10, TNF-α, IFN-γ, and TGF-β2, genomic DNA, mRNA, and microRNAs to interact with immune cells, including B cells, T cells, natural killer (NK) cells, regulatory T cells (Tregs), and tumor-associated macrophages (TAMs), thus weakening antitumor immune responses and escaping from immune surveillance [ 53 , 54 ]. CDEs can ①influence immune cell maturity: impair DC maturation by influencing IL-6 expression [ 55 ], ②inhibit immune cell proliferation: impact T cell proliferation by targeting TGF-β and NK cells proliferation and cytotoxic functions via downregulating NK associated proteins [ 56 , 57 ], ③inhibit the functions necessary for antitumor responses, ④induce apoptosis of activated immune cells, ⑤suppress immune cells activity, ⑥interfere with monocyte differentiation, ⑦skew the differentiation of myeloid precursor cells, ⑧polarize immune cells into tumor-promoting phenotypes [ 53 ].…”