Nayak Abinash, Nishank Sudhansu Sekhar
Department of Zoology, Utkal University, Vani Vihar, Bhubaneswar 751004, India.
Crit Rev Oncol Hematol. 2025 Sep 13;216:104927. doi: 10.1016/j.critrevonc.2025.104927.
Extracellular vesicles(EVs) including exosomes, microvesicles, and apoptotic bodies, have garnered significant attention for their pivotal roles in cancer metastasis. These nanometer-sized vesicles, secreted by both tumor and non-tumor cells, mediate intercellular communication by transferring bioactive molecules such as proteins, lipids, RNAs and metabolites. In the context of cancer, EVs facilitate metastasis by promoting tumor cell migration, invasion, angiogenesis, and immune evasion. Furthermore, EVs play a critical role in preparing distant organs for metastasis by shaping the Premetastatic Niche (PMN), thus creating a conductive microenvironment for tumor cell colonization. This review provides an in-depth exploration of the molecular mechanisms through which EVs influence cancer progression, with a focus on their roles in metastatic dissemination. Additionally, the emerging therapeutic strategies targeting EVs to inhibit metastasis, such as blocking EV biogenesis and secretion, disrupting EV-receptor interactions, and using EVs as delivery vehicles for targeted therapies are discussed. Moreover, exosome-based immunotherapies, which aim to enhance anti-tumor immunity, are also highlighted. While these therapeutic approaches hold great promise, challenges remain in efficiently targeting and modulating EV functions for clinical applications. Other subtypes of EVs such as Mitovesicles, Migrasomes can be further studied to explore their significant role at different stages of cancer. Improvement in cargo profiling of EVs mainly the proteins and miRNAs could be a novel noninvasive biomarker for detection of cancer. This article offers a comprehensive overview of the multifaceted roles of EVs in cancer metastasis and the potential of EV-based therapies, laying the foundation for future cancer treatment strategies.
细胞外囊泡（EVs），包括外泌体、微囊泡和凋亡小体，因其在癌症转移中的关键作用而备受关注。这些由肿瘤细胞和非肿瘤细胞分泌的纳米级囊泡，通过传递蛋白质、脂质、RNA和代谢物等生物活性分子来介导细胞间通讯。在癌症背景下，EVs通过促进肿瘤细胞迁移、侵袭、血管生成和免疫逃逸来促进转移。此外，EVs通过塑造前转移微环境（PMN），在为远处器官的转移做准备方面发挥关键作用，从而为肿瘤细胞定植创造一个有利的微环境。本综述深入探讨了EVs影响癌症进展的分子机制，重点关注它们在转移扩散中的作用。此外，还讨论了针对EVs抑制转移的新兴治疗策略，如阻断EV的生物发生和分泌、破坏EV-受体相互作用以及将EVs用作靶向治疗的递送载体。此外，旨在增强抗肿瘤免疫力的基于外泌体的免疫疗法也得到了强调。虽然这些治疗方法前景广阔，但在临床应用中有效靶向和调节EV功能仍面临挑战。EVs的其他亚型，如线粒体囊泡、迁移小体，可以进一步研究，以探索它们在癌症不同阶段的重要作用。改善EVs的货物谱分析，主要是蛋白质和微小RNA，可能成为一种用于癌症检测的新型非侵入性生物标志物。本文全面概述了EVs在癌症转移中的多方面作用以及基于EVs的治疗潜力，为未来的癌症治疗策略奠定了基础。
