Extracellular Vesicles as Surrogates for Drug Metabolism and Clearance: Promise vs. Reality

Extracellular vesicles (EVs) offer a promising, less invasive alternative to biopsies for assessing the expression and activity of drug-metabolizing enzymes (DMEs) and transporters, which are crucial for drug efficacy and safety. Preliminary evidence suggests a correlation between enzyme and transporter expression in EVs and their tissue of origin, with some data reflecting tissue induction of phase I-DMEs. However, further research is needed to confirm the extent to which tissue regulation of DMEs and transporters is mirrored in EV cargo. Establishing a strong association could lead to significant advancements in precision therapy by tailoring treatments based on individual biotransformation and excretion capacities.