The Roles of Exosomes in Ovarian Cancer Chemo-resistance

As common gynecological oncology, ovarian cancer has a high fatality rate and poor overall survival, mainly because of nonspecific symptoms in the early stages and chemotherapy resistance. Exosomes, nano-sized vesicles secreted by almost all types of cells, carry valuable commodities such as proteins, lipids, enzymes, mRNAs, and miRNAs between cells. They take part in remodeling the tumor microenvironment, promoting tumor angiogenesis and metastasis, and regulating immune metastasis and chemotherapy resistance in ovarian cancer. Previous studies have reported that exosomes could transfer chemotherapy resistance from drug-resistant tumor cells to sensitive ones by delivering proteins and miRNAs. Also, exosomes are involved in chemotherapy resistance by transferring multidrug-resistancerelated transporters, decreasing apoptosis, promoting epithelial-to-mesenchymal transition, and changing signal transduction pathways. Furthermore, they play a significant role in early detection, chemotherapy efficacy evaluation, and treatment of ovarian cancer. Exosomes are applied as chemotherapeutic delivery vehicles and therapeutic targets to inhibit anti-tumor immune responses. In addition, exosomes can be developed for cancer immunotherapy because of their immunomodulatory potential. Therefore, the article reviews the latest research progress of exosomes in ovarian cancer to elaborate on the mechanisms of exosome-mediated chemotherapy resistance in ovarian cancer patients and provide a forecast on their clinical therapeutic potential in improving chemotherapy sensitivity.

Automated summary

Ovarian cancer has a high fatality rate and poor survival due to nonspecific symptoms in early stages and chemotherapy resistance. Exosomes, nano-sized vesicles secreted by cells, play a significant role in tumor microenvironment remodeling, angiogenesis and metastasis, and immune metastasis and chemotherapy resistance in ovarian cancer. They transfer chemotherapy resistance by delivering proteins and miRNAs, and participate in resistance mechanisms such as multidrug-resistance transporters, apoptosis inhibition, epithelial-to-mesenchymal transition, and signal transduction pathway alteration. Exosomes are also important in early detection, chemotherapy efficacy evaluation, and treatment of ovarian cancer. They can be utilized as chemotherapeutic delivery vehicles and therapeutic targets, as well as for cancer immunotherapy. This article reviews the latest research progress of exosomes in ovarian cancer, elucidating the mechanisms of exosome-mediated chemotherapy resistance and discussing their therapeutic potential in improving chemotherapy sensitivity.