The infiltration of primary tumors and metastasis formation at distant sites strongly impact the prognosis and the quality of life of cancer patients. Current therapies including surgery, radiotherapy, and chemotherapy are limited in targeting the complex cell migration mechanisms responsible for cancer cell invasiveness and metastasis. A better understanding of these mechanisms and the development of new therapies are urgently needed. Extracellular vesicles (EVs) are lipid-enveloped particles involved in inter-tissue and inter-cell communication. This review article focuses on the impact of EVs released by tumor cells, specifically on cancer cell migration and metastasis. We first introduce cell migration processes and EV subtypes, and we give an overview of how tumor-derived EVs (TDEVs) may impact cancer cell migration. Then, we discuss ongoing EV-based cancer therapeutic approaches, including the inhibition of general EV-related mechanisms as well as the use of EVs for anti-cancer drug delivery, focusing on the harnessing of TDEVs. We propose a protein-EV shuttle as a route alternative to secretion or cell membrane binding, influencing downstream signaling and the final effect on target cells, with strong implications in tumorigenesis. Finally, we highlight the pitfalls and limitations of therapeutic EV exploitation that must be overcome to realize the promise of EVs for cancer therapy.
原发性肿瘤的浸润及远处转移灶的形成严重影响癌症患者的预后与生活质量。当前包括手术、放疗和化疗在内的治疗手段在靶向调控癌细胞侵袭转移的复杂细胞迁移机制方面存在局限。亟需深入理解这些机制并开发新型疗法。细胞外囊泡是参与组织间与细胞间通讯的脂质包被颗粒。本综述聚焦肿瘤细胞释放的细胞外囊泡对癌细胞迁移与转移的影响机制。首先阐述细胞迁移过程与细胞外囊泡亚型，系统概述肿瘤源性细胞外囊泡调控癌细胞迁移的潜在机制；继而探讨基于细胞外囊泡的癌症治疗策略，包括抑制细胞外囊泡相关通用机制以及利用细胞外囊泡（重点关注肿瘤源性细胞外囊泡）递送抗癌药物的研究进展；提出蛋白质-囊泡穿梭机制可作为分泌途径或细胞膜结合途径的替代路线，通过影响下游信号转导进而调控靶细胞的最终效应，该机制在肿瘤发生发展中具有重要意义；最后指出实现细胞外囊泡癌症治疗潜力必须克服的技术瓶颈与局限性。
肿瘤(癌症)患者之家