Role of exosomal non‑coding RNAs in cancer‑associated fibroblast‑mediated therapy resistance (Review).

Cancer‑associated fibroblasts (CAFs) represent an important component of the stromal cell population within the tumor microenvironment (TME) and are intricately linked to tumor growth, metastasis and drug resistance. In the TME, non‑coding RNAs present in exosomes act as essential mediators of intercellular communication. Exosomal RNAs derived from cancer cells activate CAFs, which in turn regulate cancer cell proliferation, invasion and drug resistance. Conversely, exosomal RNAs derived from CAFs contribute to therapeutic resistance in cancer by modulating survival signaling pathways, epithelial‑mesenchymal transition, programmed cell death, drug transporter expression levels and immune evasion. The present review examines the role and mechanisms of exosomal RNAs in CAF‑mediated cancer therapeutic resistance and offers recommendations for future research based on the underlying mechanisms of CAF‑induced drug resistance.