Exploring Two Tumor Treatment Strategies: Effectiveness of Ribosome Inactivating Proteins and Mesenchymal Stem Cells/MSCderived extracellular vesicles in Cancer Treatment

Simin Farokhi¹Maryamosadat Mavaei^2,3Mohammad Hasan Yousefi^4,5Arshia Fakouri¹Alireza Shadab^6,7Mohammad Hossein Abdolmohammadi^5*Hamed Afkhami^5,8,9*

• ¹Student Research Committee, USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran, Khorramabad, Lorestan, Iran
• ²Student Research Committee, Kermanshah university of Medical Sciences, Kermansha, Iran
• ³Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences,, Kermanshah, Iran
• ⁴Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Qom University of Medical Sciences, Qom, Qom, Iran
• ⁵Cellular and Molecular Research Centre, Qom University of Medical Sciences, Qom, Iran, Qom, Qom, Iran
• ⁶Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Semnan, Iran
• ⁷Iran University of Medical Sciences, Deputy of Health, Tehran, Iran, Tehran, Alborz, Iran
• ⁸Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Semnan, Iran
• ⁹Department of Medical Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran, Tehran, Alborz, Iran

Cancer is a complex and heterogeneous disease that often requires multifaceted treatment strategies to achieve optimal therapeutic outcomes. Given the limitations of single-agent therapies, particularly in the face of intricate biological signaling networks and treatment resistance, there is a growing need for combinatory approaches. This article presents a novel hypothesis: the simultaneous use of ribosome-inactivating proteins (RIPs) and mesenchymal stem cells (MSCs) or MSC-derived extracellular vesicles (EVs) in cancer treatment. RIPs, with their potent cytotoxic properties, can target tumor cells effectively, while MSCs, known for their tumor-homing abilities and regenerative potential, can serve as delivery vehicles, potentially enhancing the targeting precision and reducing the systemic toxicity of RIPs. This hypothesis explores the synergistic potential of combining these two therapeutic modalities, leveraging the advantages of both techniques to create a more effective cancer treatment strategy. By combining RIPs' ability to inhibit protein synthesis with MSCs or MSC-derived EVs' capability to modulate the tumor microenvironment and deliver therapeutic agents. This approach offers a promising avenue for overcoming cancer's inherent complexity. However, challenges remain, such as optimizing dosing protocols, addressing safety concerns, and ensuring efficient drug delivery. Future research and clinical trials are necessary to validate this combination as a viable cancer therapy.