Exosomes in cancer progression: Orchestrators of EMT, pre-metastatic niches, and therapy resistance

Irem Yalim Camci; Arzu Aysan; Nursah Ersezen; Iremnur Caglayan

doi:10.5606/fng.btd.2025.199

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.