Exosomes in Cancer: Use them or Target them?

Exosomes are small extracellular vesicles with a significant role in most processes associated with cancer. On one hand, exosomes role in the different hallmarks of cancer has been widely described, highlighting the urge to understand the potential to target communication mediated by exosomes as a novel therapeutic approach in cancer. On the other hand, exosomes stability in circulation and tumor-targeting capacity shows their applicability in the delivery of anti-cancer molecules. University of Porto researchers discuss the dual applicability of exosomes in cancer focusing on their usage for therapy improvement, or their targeting to block their supportive role in tumor progression and response to therapy. They highlight the current developments and the strategies used to enhance the potential of exosomes to become clinical partners in the treatment of cancer.

The “light” and “dark” side of exosomes in cancer

The “light” side highlights the different approaches of using exosomes-based therapy in targeting cancer. Modulation of exosomes membrane components allows a specific and efficient delivery of anti-tumor drugs, peptides and RNAi interference molecules to cancer cells. Activation of the immune system response against cancer cells through antigen presentation and phagocytosis activation also represents a relevant approach in cancer treatment. In the “dark” side we represent the ability to target exosomes biogenesis/release and uptake, impairing the role of exosomes in the different hallmarks of cancer. A multitude of endocytosis mechanisms are involved in exosomes uptake demonstrating its complexity. Targeting these mechanisms partially inhibits exosomes-mediated communication revealing the necessity of further understanding the relevance of the different endocytosis mechanisms in the cancer context. Inhibition of exosomes biogenesis/release constitutes an additional strategy on targeting exosomes-mediated communication in cancer. Rab GTPases represent one of the most promising targets due to its involvement in all stages of exosomes biogenesis.