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REVIEW

The Role of Exosomes as a Key Factor of Cytostatic Resistance in Cancer: Mechanisms of Action, Potential Biomarkers, and Possible Exosome-Based Therapies

Sandra Kałużna1,*, Monika Świerczewska1,2, Sylwia Ciesiółka1, Małgorzata Partyka1, Michał Nowicki1, Karolina Wojtowicz1
1 Department of Histology and Embryology, University of Medical Sciences in Poznan, Święcickiego 6 St. , Poznań, 60-781, Poland
2 Institute of Health Sciences, Collegium Medicum, University of Zielona Góra, Zyty 28 St., Zielona Góra, 65-046, Poland
* Corresponding Author: Sandra Kałużna. Email: email
(This article belongs to the Special Issue: Identification of potential targets and biomarkers for cancers and the exploration of novel molecular mechanisms of tumorigenesis and metastasis)

Oncology Research https://doi.org/10.32604/or.2025.070356

Received 14 July 2025; Accepted 27 October 2025; Published online 21 November 2025

Abstract

The last research focuses on the role of exosomes in cancer treatment. Exosomes are extracellular vesicles. They can be secreted by cancer cells, and they can modulate chemotherapy sensitivity. Determining exosomal content opens the possibility for guiding treatment strategies for cancer diseases. Exosomal microRNA are considered one of the prime candidates for exosomal biomarkers. Exosomal circular RNAs represent excellent biomarkers for liquid biopsy because of their stability in many types of cancer. Exosomal proteins remain reliable biomarkers also. Exosomes have emerged as promising therapeutic candidates. Their biological properties render them ideal vectors for drug delivery. Genetic modification of exosomes is an effective way to deliver material capable of modulating cellular pathways involved in drug resistance. Furthermore, exosomes have been explored as carriers for metal-chelating agents. Integrating exosome-based therapies with traditional anticancer agents aims to exploit the natural targeting abilities of exosomes to enhance drug delivery. Despite the dynamic development of this field, many mechanisms of exosome action remain incompletely understood. Therefore, it is necessary to conduct further studies that will allow for a better understanding of their role in the process of resistance and will enable the development of effective therapeutic strategies.

Keywords

Exosomes; drug resistance; cancer

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