Extracellular Vesicles-Derived MicroRNAs: Emerging Game Changers in Cancer Pathogenesis and Therapeutic Response.

Effective communication between cells is a fundamental feature of multicellular organisms, occurring through direct contact or the transfer of secreted molecules. Among these mediators, extracellular vesicles (EVs) function as biological messengers that transport bioactive molecules among cells. EVs are secreted by nearly all cell types. The interaction between tumor cells and EV components has been shown to influence various cancer-related processes, including proliferation, metastasis, stemness, chemoresistance, and immune modulation. Among the bioactive cargos of EVs, non-coding RNAs (ncRNAs), particularly microRNAs (miRNAs), play a significant role in shaping the tumor microenvironment. These EV-derived ncRNAs have emerged as promising tools for non-invasive diagnosis, prognosis, and therapeutic intervention across multiple cancer types. This review summarizes the current understanding of the functional roles of EV-derived miRNAs in cancer and highlights their potential clinical applications as novel biomarkers and therapeutic targets in cancer management.