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Panfoli et al. J Cancer Metastasis Treat 2020;6:35 Journal of Cancer
DOI: 10.20517/2394-4722.2020.50 Metastasis and Treatment

Review Open Access

The good and bad sides of exosomes: pre-
metastatic niche formation, cancer biomarker and

therapy carriers

Isabella Panfoli , Maurizio Bruschi 2
1
1 Dipartimento di Farmacia-DIFAR, Università di Genova, Genoa, Italy.
2 Laboratory of Molecular Nephrology, IRCCS Istituto Giannina Gaslini, Genoa 16147, Italy.

Correspondence to: Prof. Isabella Panfoli, Dipartimento di Farmacia-DIFAR, Università di Genova, Scuola di Scienze Mediche e
Farmaceutiche, DIFAR, Viale Benedetto XV, 3, Genoa 16132, Italy. E-mail: panfoli@difar.unige.it

How to cite this article: Panfoli I, Bruschi M. The good and bad sides of exosomes: pre-metastatic niche formation, cancer
biomarker and therapy carriers. J Cancer Metastasis Treat 2020;6:35. http://dx.doi.org/10.20517/2394-4722.2020.50

Received: 25 May 2020 First Decision: 18 Jun 2020 Revised: 2 Jul 2020 Accepted: 21 Jul 2020 Published: 27 Sep 2020
Academic Editor: Robert J. Griffin Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Exosomes, nanovesicles of endocytic origin, are secreted by most cell types; cancer cells representing no
exception. Exosomes facilitate intercellular communication as they deliver diverse proteins, mRNA, miRNA and
lipids. In this review, we discuss how exosomes represent one of the main risks associated with cancer but also
one of the most promising new tools to fight it. Exosomes appear to function as signalling molecules between the
tumour microenvironment, i.e., the complex of both cancer and stromal cells, and the rest of the body. Cancer-
derived exosomes have been shown to drive the initiation and progression of metastasis, by transporting their
cargoes to target tissues. In this respect, exosomes are implicated in cancer progression, dissemination and
therapy resistance. However, exosomes are also emerging as a key tool in precision medicine, pivotal for cancer
liquid biopsy in early diagnosis and for assessing when there is a recurrence. Profiling exosomal cancer-derived
nucleic acids by ultrasensitive next-generation sequencing along with mapping the protein profile utilizing high-
throughput proteomics will allow earlier cancer detection, therapeutic stratification and monitoring of response to
therapy. Exosomes are also a promising new tool for cancer immunotherapy. Clinically utilizing exosomes for these
applications in cancer diagnosis and therapeutics will be the next challenge.

Keywords: Biomarkers, cancer, exosomes, immunotherapy, liquid biopsy, precision medicine, proteomics

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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