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Ascites-derived exosomes (Aex) are autologous, tumor-derived vesicles isolated from the malignant ascites of patients with advanced colorectal cancer. These 60-90 nm vesicles carry a variety of immunomodulatory markers and tumor-associated antigens, most notably carcinoembryonic antigen (CEA). In clinical development, Aex is utilized as a personalized cancer vaccine. When administered subcutaneously, typically in combination with an adjuvant like granulocyte-macrophage colony-stimulating factor (GM-CSF), Aex facilitates the presentation of tumor antigens to the immune system, thereby inducing a tumor-specific cytotoxic T lymphocyte (CTL) response aimed at eradicating colorectal cancer cells.
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