Journal of Gastrointestinal Surgery

, Volume 22, Issue 4, pp 737–750 | Cite as

Exosomes in Pancreatic Cancer: from Early Detection to Treatment

  • Emily A. Armstrong
  • Eliza W. BealEmail author
  • Jeffery Chakedis
  • Anghela Z. Paredes
  • Demetrios Moris
  • Timothy M. Pawlik
  • Carl R. Schmidt
  • Mary E. Dillhoff
Review Article



Pancreatic cancer (PC) remains one of the most fatal forms of cancer worldwide with incidence nearly equal to mortality. This is often attributed to the fact that diagnosis is often not made until later disease stages when treatment proves difficult. Efforts have been made to reduce the mortality of PC through improvements in early screening techniques and treatments of late-stage disease. Exosomes, small extracellular vesicles involved in cellular communication, have shown promise in helping understand PC disease biology.


In this review, we discuss current studies of the role of exosomes in PC physiology, and their potential use as diagnostic and treatment tools.


Exosomes have a role in diagnosing pancreatic cancer and in understanding tumor biology including migration, proliferation, chemoresistance, immunosuppression, cachexia and diabetes, and have a potential role in therapy for pancreatic cancer.


Exosomal analysis is beneficial in demonstrating mechanisms behind PC growth and metastasis, immunosuppression, drug resistance, and paraneoplastic conditions. Furthermore, the use of exosomes can be beneficial in detecting early-stage PC and exosomes have potential applications as therapeutic targets.


Exosomes Pancreatic cancer Early detection of cancer 





ATP-binding cassette sub-family G member 2

Ca 19-9

Carbohydrate antigen 19-9


Cancer-associated fibroblast cells


Cell-free deoxyribonucleic acid


Cell-free ribonucleic acid


Dendritic cells


Deoxyribonucleic acid


Extracellular vesicles


Federal Drug Administration


GAIP-interacting protein C terminus




Hepatic stellate cells




Intraductal papillary mucinous neoplasm


Major histocompatibility complex


Macrophage inhibitory factor


Microribonucleic acid


Natural killer


Pancreatic cancer


Pancreatic cancer-initiating cell


Pancreatic ductal adenocarcinoma


Pancreatic stellate cells


Regulatory factor X-associated protein


Ribonucleic acid


Unfolded protein response


Tumor-associated macrophages


Toll-like receptor-4


Tumor necrosis factor-alpha


Tumor growth factor-beta



Emily Armstrong, Eliza Beal, Jeffery Chakedis, Anghela Paredes, Demetrios Moris, Timothy Pawlik, Carl Schmidt, and Mary Dillhoff conceived the idea for the project. Eliza Beal and Emily Armstrong performed the literature review. Emily Armstrong, Eliza Beal, Jeffery Chakedis, Anghela Paredes, Demetrios Moris, Timothy Pawlik, Carl Schmidt, and Mary Dillhoff prepared the manuscript, provided critical review and revision, approved the final version to be submitted, and agree to be accountable for all aspects of the work.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Emily A. Armstrong
    • 1
  • Eliza W. Beal
    • 2
    Email author
  • Jeffery Chakedis
    • 2
  • Anghela Z. Paredes
    • 2
  • Demetrios Moris
    • 2
  • Timothy M. Pawlik
    • 2
  • Carl R. Schmidt
    • 2
  • Mary E. Dillhoff
    • 2
  1. 1.The Ohio State University College of MedicineColumbusUSA
  2. 2.Department of Surgery, Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusUSA

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