Gao Yuxin, Xie Jun, Yang Zhenya, Li Mengxi, Yuan Hongfan, Li Rui
Department of Abdominal Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Information Technology Center, West China Hospital of Sichuan University, Chengdu, China.
Front Pharmacol. 2025 Mar 19;16:1485661. doi: 10.3389/fphar.2025.1485661. eCollection 2025.
Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases and remains one of the leading causes of cancer-related mortality worldwide. The high mortality rate is primarily driven by delayed diagnosis, rapid metastasis, and frequent recurrence. Tumor-derived exosomes (TEXs) have emerged as critical mediators in NSCLC progression, offering valuable insights into the tumor microenvironment. Exosomes are small membrane vesicles that facilitate intercellular communication and transport bioactive molecules, including proteins, RNAs, and DNAs, thereby reflecting the genetic complexity of tumors. These exosomes play a key role in promoting tumor metastasis, epithelial-mesenchymal transition (EMT), neovascularization, drug resistance, and immune evasion, all of which are pivotal in the development of NSCLC. This review explores the diverse roles of TEXs in NSCLC progression, focusing on their involvement in pre-metastatic niche formation, tissue metastasis, and immune modulation. Specifically, we discuss the roles of exosome-associated RNAs and proteins in NSCLC, and their contribute to tumor growth and metastasis. Furthermore, we explore the potential of TEXs as biomarkers for NSCLC, emphasizing their application in diagnosis, prognosis, and prediction of resistance to targeted therapies and immunotherapies.
非小细胞肺癌（NSCLC）约占所有肺癌病例的85%，仍是全球癌症相关死亡的主要原因之一。高死亡率主要是由诊断延迟、快速转移和频繁复发所致。肿瘤来源的外泌体（TEXs）已成为NSCLC进展中的关键介质，为肿瘤微环境提供了有价值的见解。外泌体是小的膜泡，有助于细胞间通讯并运输生物活性分子，包括蛋白质、RNA和DNA，从而反映肿瘤的遗传复杂性。这些外泌体在促进肿瘤转移、上皮-间质转化（EMT）、新血管形成、耐药性和免疫逃逸中起关键作用，所有这些在NSCLC的发展中都至关重要。本综述探讨了TEXs在NSCLC进展中的多种作用，重点关注它们在转移前生态位形成、组织转移和免疫调节中的作用。具体而言，我们讨论了外泌体相关RNA和蛋白质在NSCLC中的作用，以及它们对肿瘤生长和转移的贡献。此外，我们探讨了TEXs作为NSCLC生物标志物的潜力，强调它们在诊断、预后以及预测对靶向治疗和免疫治疗的耐药性方面的应用。
