Extracellular Vesicles As a Source of Biomarkers for Cancer Diagnosis

Abstract

Extracellular vesicles (EVs) are secreted by nearly all mammalian cells and play a major role in intercellular communication via the transport of various active biomolecules. In cancer, pathological EVs contribute to tumor progression by participating in metastasis, angiogenesis, and immune evasion. Recent advancements in EV research have revealed their potential as noninvasive biomarkers. This review addresses the latest advancements in EV isolation and characterization techniques, elucidates the molecular mechanisms underlying EV biogenesis, and examines their functional roles in cancer progression. Furthermore, we discuss emerging strategies that leverage EV profiling and molecular composition analysis, in conjunction with liquid biopsy technologies, offering possible breakthroughs in early cancer diagnosis and treatment monitoring. By synthesizing these insights, this review emphasizes the growing significance of EVs as versatile and powerful diagnostic tools in oncology.

Keywords: EVs; exosomes; extracellular vesicles; liquid biopsy; oncology.

Fig. 1

Schematic of exosomes and microvesicles biogenesis. Exosomes form via the endocytic pathway that starts with the invagination of the plasma membrane and formation of early endosomes (EEs). These endosomes mature into multivesicular bodies (MVBs) containing intraluminal vesicles (ILVs). Following fusion of MVBs with the plasma membrane, ILVs are released as exosomes (30–150 nm) into the extracellular space. Microvesicles are formed by direct budding from the plasma membrane, resulting in larger vesicles (150–1,000 nm). IDL – intermediate-density lipoprotein; ESCRT – endosomal sorting complex required for transport

Fig. 2

Application of EVs in liquid biopsy for cancer diagnosis. Key elements analyzed by liquid biopsy include circulating cell-free DNA (cfDNA), extracellular vesicles (EVs), mRNAs, circulating tumor cells (CTCs), and tumor-derived metabolites