Irem Yalim CAMCI, Arzu AYSAN, Nursah ERSEZEN, Iremnur CAGLAYAN
Demiroğlu Bilim Üniversitesi Florence Nightingale Tıp Dergisi - 2025;11(3):159-168
Exosome-mediated communication has become a crucial mechanism by which tumor and stromal cells synchronize malignant behavior. These nanoscale vesicles function as dynamic carriers, delivering a varied array of functional molecules that facilitate critical tumor-promoting processes, such as fibroblast activation, extracellular matrix remodeling, metabolic reprogramming, and immune modulation. Cancer cells dynamically adjust to environmental stress, circumvent therapeutic pressure, and create pre-metastatic niches through these multifactorial actions. Increasing evidence indicates that exosome-derived RNAs and proteins contribute to drug resistance and hold promise as predictive biomarkers of treatment response. This review summarizes recent advances in understanding how exosome-driven molecular interactions integrate signaling and metabolic networks to promote tumor progression. Furthermore, it highlights the translational potential of targeting exosomal pathways as a novel therapeutic strategy to overcome resistance and improve cancer treatment.
