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This review summarizes senEV biogenesis, cargo\u2010dependent functions, and immune\u2010remodelling effects while distinguishing mechanisms directly demonstrated in experimentally validated senescent\u2010cell EV models from contextual evidence derived from broader EV and mitochondrial\u2010stress studies. Direct evidence shows that senEVs can support immune\u2010mediated clearance in some models or promote tumour growth, chemoresistance, and polymorphonuclear myeloid\u2010derived suppressor cell (PMN\u2010MDSC)\u2010mediated immunosuppression in others. We further evaluate mitochondrial stress and EV\u2010associated mitochondrial DNA as an emerging mechanistic framework that may contribute to these divergent outcomes, rather than as an established general regulator of senEV activity. Finally, we discuss candidate intervention strategies, evidence gaps, and the experimental requirements needed to define how donor\u2010cell state, cargo composition, recipient\u2010cell identity, treatment context and time after treatment may shape senEV function.<\/jats:p>","DOI":"10.1002\/jex2.70193","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:57:53Z","timestamp":1792061873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Senescent Cell\u2010Derived Extracellular Vesicles in Therapy\u2010Induced Senescence: Immune Remodelling and Emerging Links to Mitochondrial Stress in Cancer"],"prefix":"10.1002","volume":"5","author":[{"given":"Yongrui","family":"Qian","sequence":"first","affiliation":[{"name":"State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection Suzhou Medical College of Soochow University  Suzhou Jiangsu P.R. 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