Exosomal long non-coding RNAs in gastrointestinal cancer: chemoresistance mediators and therapeutic targets

Gastrointestinal (GI) cancer is a series of malignant cancer mainly affecting the GI tract. Chemotherapy is one of the most treatment strategies used in GI cancer treatment, especially in advanced cases. However, the challenge of chemoresistance significantly compromises treatment success, resulting in poorer clinical outcomes and increased metastatic potential. Long non-coding RNAs (lncRNAs) have emerged as important regulators of gene expression and are implicated in various disease processes. Recent research has demonstrated that lncRNAs can be packaged within exosomes, thereby facilitating intercellular communication and potentially transferring chemoresistance traits among cancer cells. This review focuses on the biogenesis and functional roles of exosomal lncRNAs in promoting chemoresistance across different GI cancers. We highlight specific lncRNAs, elucidate their mechanisms of action, and discuss innovative therapeutic strategies aimed at targeting these molecules in gastrointestinal malignancies. By exploring these intricate interactions, we aim to identify novel approaches to overcome chemoresistance and improve the efficacy of treatments for GI cancer.