Extracellular vesicles in prostate cancer: current understanding and future perspectives

Area of Science:

• Cell Biology
• Biochemistry
• Oncology

Background:

• Exosomes are nanoscale extracellular vesicles mediating intercellular communication.
• They contain diverse molecular cargo, influencing recipient cell function.
• Prostate cancer (PCa) presents diagnostic and therapeutic challenges, including limitations of prostate-specific antigen (PSA) screening.

Purpose of the Study:

• To review exosome biology in PCa, focusing on their roles and biomarker potential.
• To highlight exosomes as superior biomarkers compared to PSA.
• To discuss challenges and future directions for exosome-based PCa diagnostics.

Main Methods:

• Comprehensive literature review (2016-2025) of PubMed, Embase, Cochrane Library, and clinicaltrials.org.
• Analysis of exosome biogenesis, cargo, and functional roles in PCa progression.
• Evaluation of exosome stability and biomarker potential for PCa-specific markers.

Main Results:

• Exosomes play roles in PCa progression, angiogenesis, immune evasion, metastasis, and therapy resistance.
• Exosomal cargo (e.g., AR-V7, PCA3, ERG mRNAs, PSMA) is protected from degradation, offering stable biomarkers.
• Urine and prostatic secretion-derived exosomes show potential for early diagnosis, prognosis, and treatment monitoring.

Conclusions:

• Exosomes represent a promising avenue for overcoming PSA screening limitations in PCa.
• Standardized isolation and addressing tumor heterogeneity are key challenges.
• Future research should focus on hybrid isolation, cell-specific profiling, and AI-driven multi-omics for improved PCa biomarkers.