Extracellular vesicles (EVs) play a critical role in intercellular communication and cancer progression by transferring diverse cargoes, including lipids, proteins, and nucleic acids. Recent studies have shown that EVs can regulate nonapoptotic forms of regulated cell death (RCD), such as ferroptosis, pyroptosis, and necroptosis, which are important in cancer development and therapy. These nonapoptotic RCD forms are regulated by various biomacromolecules and influence cancer progression. EVs can mediate these processes by delivering specific cargoes that regulate oncogenes and tumor suppressors. The potential clinical applications of EV-mediated cell death in cancer therapy are significant, as they can be used for diagnosis and treatment. EVs can also be used to deliver drugs and therapeutic agents to cancer cells, enhancing their efficacy. The review highlights the importance of understanding the mechanisms of EV-mediated RCD in cancer and the potential for developing new therapeutic strategies based on this knowledge. The review also discusses the challenges and opportunities in using EVs for cancer therapy, including the need for further research on the mechanisms of EV biogenesis and transport, as well as the potential for developing more effective and targeted treatments. Overall, the study emphasizes the importance of EVs in cancer research and their potential for improving cancer diagnosis and treatment.Extracellular vesicles (EVs) play a critical role in intercellular communication and cancer progression by transferring diverse cargoes, including lipids, proteins, and nucleic acids. Recent studies have shown that EVs can regulate nonapoptotic forms of regulated cell death (RCD), such as ferroptosis, pyroptosis, and necroptosis, which are important in cancer development and therapy. These nonapoptotic RCD forms are regulated by various biomacromolecules and influence cancer progression. EVs can mediate these processes by delivering specific cargoes that regulate oncogenes and tumor suppressors. The potential clinical applications of EV-mediated cell death in cancer therapy are significant, as they can be used for diagnosis and treatment. EVs can also be used to deliver drugs and therapeutic agents to cancer cells, enhancing their efficacy. The review highlights the importance of understanding the mechanisms of EV-mediated RCD in cancer and the potential for developing new therapeutic strategies based on this knowledge. The review also discusses the challenges and opportunities in using EVs for cancer therapy, including the need for further research on the mechanisms of EV biogenesis and transport, as well as the potential for developing more effective and targeted treatments. Overall, the study emphasizes the importance of EVs in cancer research and their potential for improving cancer diagnosis and treatment.