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. 2025 Jan 18;26(2):802.
doi: 10.3390/ijms26020802.

Exosomal Liquid Biopsy in Prostate Cancer: A Systematic Review of Biomarkers for Diagnosis, Prognosis, and Treatment Response

Yameen Hamid  1   2 , Rukhshana Dina Rabbani  3 , Rakkan Afsara  4 , Samarea Nowrin  5 , Aruni Ghose  3 , Vasileios Papadopoulos  6 , Konstantinos Sirlantzis  7 , Saak V Ovsepian  8   9 , Stergios Boussios  3   10   11   12   13
Affiliations

Exosomal Liquid Biopsy in Prostate Cancer: A Systematic Review of Biomarkers for Diagnosis, Prognosis, and Treatment Response

Yameen Hamid et al. Int J Mol Sci. .

Abstract

Prostate cancer, a leading cause of cancer-related mortality among men, often presents challenges in accurate diagnosis and effective monitoring. This systematic review explores the potential of exosomal biomolecules as noninvasive biomarkers for the diagnosis, prognosis, and treatment response of prostate cancer. A thorough systematic literature search through online public databases (Medline via PubMed, Scopus, and Web of science) using structured search terms and screening using predefined eligibility criteria resulted in 137 studies that we analyzed in this systematic review. We evaluated the findings from these clinical studies, revealing that the load of exosomes in the blood and urine of prostate cancer patients, which includes microRNAs (miRNAs), proteins, and lipids, demonstrates disease-specific changes. It also shows that some exosomal markers can differentiate between malignant and benign hyperplasia of the prostate, predict disease aggressiveness, and monitor treatment efficacy. Notably, miRNA emerged as the most frequently studied biomolecule, demonstrating superior diagnostic potential compared to traditional methods like prostate-specific antigen (PSA) testing. The analysis also highlights the pressing need for a standardised analytic approach through multi-centre studies to validate the full potential of exosomal biomarkers for the diagnosis and monitoring of prostate cancer.

Keywords: biomarkers; exosomes; liquid biopsy; miRNA; prognosis; prostate cancer; response.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the systematic review.
Figure 2
Figure 2
Distribution of selected articles based on year of publication.
Figure 3
Figure 3
Bar chart of selected article numbers studying different exosomal components as prostate cancer liquid biopsy biomarkers.
Figure 4
Figure 4
Bar chart of selected article numbers studying the particular role of exosomal components in prostate cancer.
See this image and copyright information in PMC

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