Cellular Oncology

, Volume 41, Issue 3, pp 223–252 | Cite as

The versatile role of exosomes in cancer progression: diagnostic and therapeutic implications

  • Vignesh Sundararajan
  • Fazlul H. Sarkar
  • Thamil Selvee Ramasamy



Recent advances in cancer biology have highlighted the relevance of exosomes and nanovesicles as carriers of genetic and biological messages between cancer cells and their immediate and/or distant environments. It has been found that these molecular cues may play significant roles in cancer progression and metastasis. Cancer cells secrete exosomes containing diverse molecules that can be transferred to recipient cells and/or vice versa to induce a plethora of biological processes, including angiogenesis, metastasis formation, therapeutic resistance, epithelial-mesenchymal transition and epigenetic/stemness (re)programming. While exosomes interact with cells within the tumour microenvironment to promote tumour growth, these vesicles can also facilitate the process of distant metastasis by mediating the formation of pre-metastatic niches. Next to their tumour promoting effects, exosomes have been found to serve as potential tools for cancer diagnosis and therapy. The ease of isolating exosomes and their content from different body fluids has led to the identification of diagnostic and prognostic biomarker signatures, as well as to predictive biomarker signatures for therapeutic responses. Exosomes can also be used as cargos to deliver therapeutic anti-cancer drugs, and they can be engineered to serve as vaccines for immunotherapy. Additionally, it has been found that inhibition of exosome secretion, and thus the transfer of oncogenic molecules, holds promise for inhibiting tumour growth. Here we provide recent information on the diverse roles of exosomes in various cellular and systemic processes governing cancer progression, and discuss novel strategies to halt this progression using exosome-based targeted therapies and methods to inhibit exosome secretion and the transfer of pro-tumorigenic molecules.


This review highlights the important role of exosomes in cancer progression and its implications for (non-invasive) diagnostics and the development of novel therapeutic strategies, as well as its current and future applications in clinical trials.


Exosomes Extracellular vesicles Metastasis Tumour microenvironment Anti-cancer therapeutics Pre-metastatic niche Angiogenesis Metastasis Drug resistance Epithelial-mesenchymal transition 



This work was supported by University of Malaya Programme Grant RP032-14HTM. The authors would like to thank Miss Yew Hong Wen, from Stem Cell Biology Laboratory, for her assistance in preparing the artwork and figures.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© International Society for Cellular Oncology 2018

Authors and Affiliations

  • Vignesh Sundararajan
    • 1
  • Fazlul H. Sarkar
    • 2
  • Thamil Selvee Ramasamy
    • 3
    • 4
  1. 1.Department of Biotechnology, School of BioengineeringSRM Institute of Science and TechnologyKattankulathurIndia
  2. 2.Department of PathologyWayne State University School of MedicineDetroitUSA
  3. 3.Stem Cell Biology Laboratory, Department of Molecular Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  4. 4.Cell and Molecular Biology Laboratory, Faculty of Medicine Dean’s OfficeUniversity of MalayaKuala LumpurMalaysia

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