Exosomes: Potent regulators of tumor malignancy and potential bio-tools in clinical application

Multiple lines of evidence indicate that exosomes, as efficient messengers in cell-to-cell communication, play pleiotropic roles in regulating tumor malignancy. The cargos (proteins, mRNAs, and miRNAs) carried by exosomes can be functionally delivered between different types of cells and even transferred to distant locations, influencing the biological activities of tumor and non-tumor cells and promoting tumor growth, invasion, metastasis, angiogenesis, and drug resistance. Tumor-associated exosomes have been identified in biological (plasma, urine, saliva) and pathological (malignant effusions, pleural effusions, ascites) fluids from cancer patients. The contents of exosomes may vary depending on tumor types and status. Detection of exosomes in biofluids of cancer patients may represent a promising strategy to gain pathogenic information and to select specific biomarkers for the diagnosis and prognosis of cancer. Utilization of exosomes as delivery vehicles for siRNAs and therapeutic drugs brings out new concepts such as biomimetics in cancer treatment. In this review, we will mainly discuss emerging roles of exosomes in tumor invasion, metastasis, angiogenesis, and drug resistance and potential clinical application of exosomes as biomarkers and therapeutic tools.