Exosomes in cancer progression: Orchestrators of EMT, pre-metastatic niches, and therapy resistance
Irem Yalim Camci1
, Arzu Aysan1, Nursah Ersezen1, Iremnur Caglayan2
1Department of Molecular Biology and Genetics, Gebze Technical University, Kocaeli, Türkiye
2Department of Biology, Dokuz Eylül University, İzmir, Türkiye
Keywords: Cancer, cancer micro-environment, drug-resistance, exosome.
Abstract
Exosome-mediated communication has become a crucial mechanism by which tumor and stromal cells synchronize malignant behavior. These nanoscale vesicles function as dynamic carriers, delivering a varied array of functional molecules that facilitate critical tumor-promoting processes, such as fibroblast activation, extracellular matrix remodeling, metabolic reprogramming, and immune modulation. Cancer cells dynamically adjust to environmental stress, circumvent therapeutic pressure, and create pre-metastatic niches through these multifactorial actions. Increasing evidence indicates that exosome-derived RNAs and proteins contribute to drug resistance and hold promise as predictive biomarkers of treatment response. This review summarizes recent advances in understanding how exosome-driven molecular interactions integrate signaling and metabolic networks to promote tumor progression. Furthermore, it highlights the translational potential of targeting exosomal pathways as a novel therapeutic strategy to overcome resistance and improve cancer treatment.
Cite this article as: Camci IY, Aysan A, Ersezen N, Caglayan I. Exosomes in cancer progression: orchestrators of EMT, pre-metastatic niches, and therapy resistance. D J Med Sci 2025;11(3):159-168. doi: 10.5606/fng.btd.2025.199.
I.Y.C., A.A.: Contributed substantially to the conception and design of the review. I.YC, A.A, N.E, I.C.: The literature search and selection were performed collaboratively by all authors. Data collection, analysis, and interpretation of the relevant studies were carried out jointly. All authors participated in the critical evaluation and synthesis of the literature. The manuscript was written collectively, and all authors contributed to drafting and revising the article critically for important intellectual content. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.