Open Access

REVIEW

Exosomal Non-Coding RNAs in Pancreatic Cancer: From Mechanisms to Clinical Applications

Chengru Yang^1,#, Zhiyu Wang^1,#, Shaowu Bi¹, Xinmiao Zhang¹, Zhaoqiang Xu¹, Yifei Ge¹, Tianjie Zhang¹, Nan Wang¹, Yi Xu^{1,2,3,4,5,6,7,8,9,*}, Xiangyu Zhong^1,*

1 Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, 150086, China
2 State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Medical University, Nanning, 530021, China
3 Key Laboratory of Functional and Clinical Translational Medicine, Fujian Province University, Xiamen Medical College, Xiamen, 361000, China
4 Key Laboratory of Human Development and Disease Research (Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, 530021, China
5 Key Laboratory of Biological Molecular Medicine Research (Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning, 530021, China
6 Fujian Provincial Key Laboratory of Tumor Biotherapy, Fuzhou, 350014, China
7 Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, 350014, China
8 School of Pharmacy, Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Bengbu Medical University, Bengbu, 223913, China
9 Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, 999077, China

* Corresponding Authors: Yi Xu. Email: ; Xiangyu Zhong. Email:
# These authors contributed equally to this work and share first authorship

(This article belongs to the Special Issue: New Insights in Drug Resistance of Cancer Therapy: A New Wine in an Old Bottle)

Oncology Research 2025, 33(11), 3207-3229. https://doi.org/10.32604/or.2025.066150

Received 31 March 2025; Accepted 27 August 2025; Issue published 22 October 2025

Abstract

Pancreatic cancer (PC) is an extremely aggressive cancer of the digestive system with insidious onset and the lack of effective biomarkers, resulting in late-stage diagnosis and poor prognosis. Exosomal non-coding RNAs (ncRNAs) are key mediators of intercellular communication that drive PC initiation and advancement. By modulating gene expression, they impact tumor microenvironment (TME) remodeling, proliferation, migration, apoptosis, and immune evasion. Critically, exosomal ncRNAs serve as promising biomarkers for early diagnosis and prognostic assessment. This review summarizes the current research achievements regarding exosomal ncRNAs in PC, systematically elaborating on their roles in tumor occurrence, metastasis, chemoresistance and the TME. Furthermore, by integrating the potential of exosomal ncRNAs in the diagnosis, treatment and prognosis of PC and by highlighting the challenges and future directions, this review aims to offer novel insights for future research and clinical translation of exosomal ncRNAs in PC.

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Keywords

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