Abstract Growing evidence indicates that tumor cells exhibit characteristics similar to their lineage progenitor cells. We found that S100 calcium binding protein A10 (S100A10) exhibited an expression pattern similar to that of liver progenitor genes. However, the role of S100A10 in hepatocellular carcinoma (HCC) progression is unclear. Furthermore, extracellular vesicles (EVs) or exosomes are critical mediator of tumorigenesis and metastasis, but the extracellular functions of S100A10, particularly those related to EVs (EV-S100A10), are unknown. In this study, we observed that S100A10 was upregulated at mRNA level in patients’ HCC tumors as compared to the corresponding non-tumorous livers, associated with a copy-number gain. Overexpression of S100A10 was correlated with more aggressive tumor features and poor prognosis. Furthermore, functional assays demonstrated it promoted HCC initiation and progression, including increased sphere forming ability in vitro, enhanced chemoresistance, upregulated liver cancer stemness markers and activated AKT and ERK pathways. In addition, in orthotopic injection mouse model, S100A10 enhanced both the intrahepatic and pulmonary metastasis of HCC xenografts, with upregulated epithelial-mesenchymal transition (EMT) changes. Of significance, we found that S100A10 was present in EVs secreted by HCC cells. Functionally, the EVs secreted by HCC cells promoted the migratory and invasive abilities of recipient HCC cells. Consistent with the oncogenic role of S100A10 in HCC, EVs from S100A10-overexpressing HCC cells enhanced the tumor promoting effects, while the S100A10-depleted HCC cells abrogated the effects, as compared to the vector control group. To further consolidate the tumor promoting role of S100A10-EV, we blocked the effects using neutralizing antibody (NA) by pretreating HCC cells with S100A10 NA together with EV. Indeed, the NA significantly abrogated the stemness and metastatic properties induced by S100A10-EVs both in vitro and in vivo. In addition, the EMT changes and activation of AKT and ERK were also validated in the recipient HCC cells with the S100A10-EV treatment, while they were abolished with the NA treatment. Moreover, we found that S100A10 governed the protein cargos in EVs and mediated the binding of MMP2, fibronectin and EGF to EV membranes through physical binding with integrin αV to promote the motility of recipient cells. Of note, we observed a simultaneous change of p-EGFR, indicating potential activation of AKT and ERK induced by EGFR. On the other hand, we found the plasma EV-S100A10 level was relatively higher in HCC patients than healthy donors. Collectively, the data showed that S100A10 could be transferred among cells through EVs and activated signaling pathways to facilitate metastasis. Targeting S100A10 may be a potential therapeutic strategy for HCC. Citation Format: Lu TIAN, Xia WANG, Jingyi LU, HongYang Huang, Goofy Yu-Man Tsui, Karen Man-Fong Sze, Tan-To Cheung, Irene Oi-Lin NG. S100A10 promotes HCC development and progression via transfer in extracellular vesicles and regulating their protein cargos. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3985.