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Review
. 2025 Jul 8;25(1):1154.
doi: 10.1186/s12885-025-14375-7.

Extracellular Vesicles in cancer: from isolation and characterization to metastasis, drug resistance, and clinical applications

Ancuta Jurj  1 , Doru Paul  2 , George A Calin  3   4
Affiliations
Review

Extracellular Vesicles in cancer: from isolation and characterization to metastasis, drug resistance, and clinical applications

Ancuta Jurj et al. BMC Cancer. .

Abstract

Cancer progression, along with other hallmarks of cancer, is sustained through bidirectional cell-to-cell communication. This function is primarily facilitated by lipid-rich nanoparticles expelled into the extracellular matrix by stromal and/or malignant cells. These entities, known as extracellular vesicles, contain a vast repertoire of bioactive molecules and hold promise as potential biomarkers and nanovehicles for drug delivery. Intriguingly, the cellular and molecular mechanisms governing the functions of extracellular vesicles remain poorly understood. In the present manuscript, we highlight the intracellular and intercellular journey of extracellular vesicles, from their inception to the present day, their implications in various hallmarks of cancer, and their clinical applications.

Keywords: Biomarkers; Cancer progression; Drug resistance; Extracellular vesicles.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publications: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Extracellular vesicles biogenesis and cargo profile. A EVs originate from plasma membrane budding (microvesicles) or as intraluminal vesicles within multivesicular endosomes. Multivesicular endosomes fuse with the plasma membrane, releasing intraluminal vesicles as exosomes. B EV composition varies by cell type and conditions, carrying proteins, lipids, and nucleic acids that influence their function. Selective cargo sorting is crucial, as EVs display cell-type-specific proteins that determine their fate and role. This image was created with BioRender.com
Fig. 2
Fig. 2
EVs could serve as valuable biomarkers for diagnosis, prognosis, and disease monitoring in clinical research. Various traditional and advanced methodologies facilitate their isolation, biophysical and molecular characterization, and cargo profiling. Given their critical roles in tumorigenesis, progression, and metastasis, EVs hold significant potential for liquid biopsy applications. This image was created with BioRender.com
Fig. 3
Fig. 3
Drug-resistant tumor cells can transfer resistance traits to drug-sensitive tumor cells via exosome exchange. These exosomes serve as carriers for proteins, including drug-efflux pumps, as well as nucleic acids such as miRNAs, circRNAs, and lncRNAs, all of which play pivotal roles in mediating drug resistance. This image was created with BioRender.com
See this image and copyright information in PMC

References

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