Exosomes in cancer development

Exosomes are secreted small extracellular vesicles (EVs) packaged with diverse biological cargo. They mediate complex intercellular communications among cells in maintenance of normal physiology or to trigger profound disease progression. Increasing numbers of studies have identified exosome-mediated functions contributing to cancer progression, including roles in paracrine cell-to-cell communication, stromal reprogramming, angiogenesis, and immune responses. Despite the growing body of knowledge, the specific role of exosomes in mediating pre-cancerous conditions is not fully understood and their ability to transform a healthy cell is still controversial. Here we review recent studies describing functions attributed to exosomes in different stages of carcinogenesis. We also explore how exosomes ultimately contribute to the progression of a primary tumor to metastatic disease.