Aug 2026· Medicina· Vol 62, pp. 1538· 0 citations· 51 references
Medicine
TL;DR
This review provides a comprehensive overview of exosome biogenesis, molecular composition, and their functional roles in CRC pathogenesis, with particular emphasis on translational and surgical oncology implications.
Abstract
Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide despite advances in screening, surgical techniques, and systemic therapies. In recent years, exosomes—nanoscale extracellular vesicles involved in intercellular communication—have emerged as critical regulators of CRC biology. Exosomes mediate tumor progression, metastatic dissemination, immune evasion, and therapeutic resistance through the transfer of bioactive molecules including proteins, lipids, and non-coding RNAs. Moreover, exosomes have gained increasing attention as promising liquid biopsy tools and therapeutic platforms due to their stability, biocompatibility, and ability to reflect tumor molecular dynamics. This review provides a comprehensive overview of exosome biogenesis, molecular composition, and their functional roles in CRC pathogenesis. We further discuss their diagnostic and prognostic value, involvement in therapeutic resistance, and emerging therapeutic applications, with particular emphasis on translational and surgical oncology implications. Finally, we highlight current limitations and future perspectives for clinical integration of exosome-based strategies in CRC management.
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This review critically examines exosome sources, isolation and characterization methodologies, cargo-loading strategies, biodistribution, pharmacokinetics, and engineering approaches together with their applications in delivering small-molecule drugs and nucleic acid-based therapeutics to overcome multidrug resistance...
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Exosomes, enriched with cancer-specific nucleic acids and proteins, have emerged as key intercellular communicators for orchestrating a tripartite axis of the tumor microenvironment (TME). They contribute significantly to tumor progression, particularly through their involvement in drug resistance, immune suppression,...
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