Role of tumor-derived extracellular vesicles in cancer progression and their clinical applications (Review)

Extracellular vesicles (EVs), including micro-vesicles and exosomes, are heterogeneous small membranous vesicles shed from the surface of myriad cells and are crucial in mediating intercellular communication. The vertical trafficking of cargo to the plasma membrane and subsequent redistribution of surface lipids may contribute to EV formation. Tumor-derived extracellular vesicles (TD-EVs) can carry complex, bioactive cargo, such as nucleic acids and proteins, during tumor metastasis. Paracrine information gets relayed by TD-EVs to adjacent tumor cells and this allows a crosstalk between malignant cells. These structures may even move to a distant metastatic lesion and modulate the tumor microenvironment to form a premetastatic niche. Thus, TD-EVs might be potential biomarkers for tumor development and metastasis. Additionally, EVs are promising candidates for use as cell-free vaccines or as vehicles for the delivery of specific tumor therapeutic molecules. Genetically modified microvesicles and engineered exosomes have shed light on a novel strategy for tumor-targeted gene therapy. This review focuses on the role of EVs in tumor development and metastasis and their possible applications in the advanced diagnosis and therapy of cancer and personalized medicine.