Exosomes are extracellular nanovesicles naturally produced by inward of the cell membrane and are involved in cell-to-cell communication and content exchange. They have specific characteristics in terms of dimension, structure and surface proteins expression and they can be loaded with drugs for specific tumor cell targeting. These features allow them to avoid immune response, to enhance the immune system against cancer cells, to take advantage of EPR effect (for accumulation of drug in a specific area, for diagnosis) and to efficiently target the therapy to tumor cells, with consequentially less drug side effects and more protection of the drug or biological compound.