Ethosome-based drug delivery system for precision targeting and tumour microenvironment reprogramming in non-invasive skin cancer therapy

The non-invasive skin cancer, especially that of the basal cell carcinoma and squamous cell carcinoma, is an increasing global health burden. Traditional methods of treatment, such as surgery, cryotherapy, and topical chemotherapeutics, are all limited by poor penetration into the skin, non-specific drug delivery, cosmetic destruction, and tumour reappearance. Moreover, the tumour microenvironment (TME) significantly contributes to disease progression through inflammation, angiogenesis, immunosuppression, and therapeutic resistance, underscoring the need for more advanced, targeted treatment methods. The purpose of this review is to critically analyse the applications of the ethosome-based drug delivery system in the precision targeting and reprogramming of the TME in the treatment of non-invasive skin cancer. Ethosomes have better skin permeability and local drug delivery than standard topical systems. They also facilitate easy access to a wide variety of therapeutic agents, allowing specific interactions with tumour tissue and other critical components of the TME, leading to better therapeutic effects with fewer off-target effects. The ethosome-based drug delivery system is an attractive non-invasive therapeutic platform for managing skin cancer by efficiently reprogramming the TME via transdermal delivery. Although they have preclinical evidence supporting their potential, they need additional clinical validation and regulatory standardisation to be successfully translated into clinical use.