Extracellular vesicles play a key role in anticancer drug resistance

Despite significant advances in cancer treatment, drug resistance remains an ongoing challenge. Cancer cells can often develop resistance to treatments such as chemotherapy, radiation therapy and immunotherapy, resulting in reduced treatment effectiveness. Recent research published in Medcomm-Oncology shows that extracellular vesicles (EVs) play a central role in promoting this resistance by acting as “messengers” between cells.

The research team led by Prof. Jun Yang of Kunming Medical University studied how EVs, which are tiny lipid-bound particles released by cells, transport proteins, RNA, DNA and other molecules between cancer cells and their microenvironment . These EVs carry resistance factors and help sensitive cancer cells develop drug resistance from already resistant cells. This intercellular communication not only affects the cancer cells themselves, but also involves cells in the tumor microenvironment, such as fibroblasts and immune cells, promoting tumor growth and resistance to therapy.

An important example is chemotherapy resistance, in which cancer cells release EVs loaded with long non-coding RNAs such as AC116025.2. These RNAs interact with sensitive cancer cells, allowing them to develop resistance to the widely used chemotherapy drug 5-FU. Similarly, EVs in radiotherapy have been shown to carry miRNAs that inhibit apoptosis (programmed cell death) in cancer cells, making them radioresistant.

In addition to resistance to therapy, EVs are proving to be promising biomarkers due to their stability and easy detectability in body fluids. By monitoring the molecular charge in EVs, doctors may be able to predict which tumors are likely to develop resistance to treatment. Additionally, there is potential to restore treatment sensitivity in resistant tumors by targeting EVs themselves – preventing their production or blocking their uptake by cancer cells.

According to Prof. Yang, “Understanding the mechanisms of EV-mediated drug resistance opens new avenues for treatment. By targeting EVs, we may be able to reverse resistance and improve the effectiveness of current therapies.”

This research highlights the urgent need for innovative approaches in cancer treatment, with a focus on manipulating EVs to curb therapy resistance and improve patient outcomes. The review provides a comprehensive understanding of EV-mediated communication in cancer and paves the way for future studies to explore their potential as both therapeutic targets and diagnostic tools.