Emerging role of exosomes in cancer progression and tumor microenvironment remodeling

Cancer is one of the leading causes of death worldwide, and the factors responsible for its progression need to be elucidated. Exosomes are structures with an average size of 100 nm that can transport proteins, lipids, and nucleic acids. This review focuses on the role of exosomes in cancer progression and therapy. We discuss how exosomes are able to modulate components of the tumor microenvironment and influence proliferation and migration rates of cancer cells. We also highlight that, depending on their cargo, exosomes can suppress or promote tumor cell progression and can enhance or reduce cancer cell response to radio- and chemo-therapies. In addition, we describe how exosomes can trigger chronic inflammation and lead to immune evasion and tumor progression by focusing on their ability to transfer non-coding RNAs between cells and modulate other molecular signaling pathways such as PTEN and PI3K/Akt in cancer. Subsequently, we discuss the use of exosomes as carriers of anti-tumor agents and genetic tools to control cancer progression. We then discuss the role of tumor-derived exosomes in carcinogenesis. Finally, we devote a section to the study of exosomes as diagnostic and prognostic tools in clinical courses that is important for the treatment of cancer patients. This review provides a comprehensive understanding of the role of exosomes in cancer therapy, focusing on their therapeutic value in cancer progression and remodeling of the tumor microenvironment.

Automated summary

This review discusses the role of exosomes in cancer progression, therapy, and regulation of the tumor microenvironment. The study found that exosomes can influence cancer cell proliferation and migration rates by modulating components of the tumor microenvironment. Depending on their cargo, exosomes can promote or suppress tumor cell progression and enhance or reduce the response to radiotherapy and chemotherapy. Additionally, exosomes can trigger chronic inflammation and lead to immune evasion and tumor progression by transferring RNA and modulating molecular signaling pathways. Moreover, exosomes can serve as carriers of anti-tumor agents and genetic tools to control cancer progression. Finally, exosomes are valuable diagnostic and prognostic tools in the treatment of cancer patients.