16 - The Emerging Roles and Clinical Potential of Exosomes in Cancer: Drug Resistance

Abstract

In developed countries, drug resistance is the principle cause of death for an array of cancer types. Executing approaches that disarm drug-resistant cells is essential for both clinical and chemotherapeutic efficacy. Exosomes—as a fundamental member of extracellular vesicles—are an effective delivery system for the transportation of bioactive molecules across the cell membrane. Substantial data have revealed cancer-derived exosomes to be a key cause of intrinsic and acquired drug resistance. Exosomes can influence drug resistance through three mechanisms, including exosome-mediated direct drug efflux, transportation of drug resistance via exosomal contents, and cross-talk between tumor and stromal cells. The roles of exosomes in cancer drug resistance have been reported in a variety of cancers, including leukemia, breast cancer, prostate cancer, ovarian cancer, and other malignancies. Exosomes contain a variety of proteins, ligands, mRNAs, and miRNAs that have pleiotropic functions in cancer drug resistance. In this chapter, we specifically discuss the emerging roles and clinical potential of exosomes in cancer drug resistance.