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Advances in Exosomes and Cancer Biomarkers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Biomarkers".

Deadline for manuscript submissions: 24 July 2026 | Viewed by 2475

Special Issue Editor


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Guest Editor
1. Department of Radiation Medicine, James M. Slater, MD Proton Treatment & Research Center, Loma Linda University Health, Loma Linda, CA 92350, USA
2. Division of Biochemistry, Department of Basic Science, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
Interests: radiation; general surgery; cancers; exosomes; cancer biomarkers; liquid biopsy; tumor microenvironment; molecular diagnosis

Special Issue Information

Dear Colleagues,

Exosomes have emerged as key players in cancer biology, acting as carriers of molecular information between tumor cells and their microenvironment. In recent years, significant progress has been made in understanding the role of exosomes in cancer, particularly as potential biomarkers for diagnoses, prognoses, and treatment monitoring. These nanosized extracellular vesicles are capable of transporting proteins, lipids, and nucleic acids, reflecting the molecular landscape of their cell of origin. This has opened new avenues for the development of non-invasive diagnostic tools, especially in the context of liquid biopsies. Despite these advances, challenges remain in standardizing the isolation and analysis of exosomes, and further research is needed to validate their utility as reliable cancer biomarkers across different malignancies. This Special Issue is intended to reflect the recent developments and the ongoing challenges in leveraging exosomes as biomarkers to improve cancer outcomes.

Dr. Nathan Wall
Guest Editor

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Keywords

  • exosomes
  • cancer biomarkers
  • liquid biopsy
  • tumor microenvironment
  • molecular diagnosis

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Published Papers (3 papers)

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Research

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17 pages, 4843 KB  
Article
Extracellular Vesicle IL5RA and BCMA in Serum Enable Non-Invasive Risk Stratification of Multiple Myeloma
by Yuko Shirouchi, Hiroki Shinchi, Yoshimi Haga, Yuko Mishima, Sayuri Minowa, Tomoko Takayama, Shunji Takahashi, Dai Maruyama and Koji Ueda
Cancers 2026, 18(7), 1116; https://doi.org/10.3390/cancers18071116 - 30 Mar 2026
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Abstract
Background/Objectives: Multiple myeloma (MM) is an incurable plasma cell neoplasm in which diagnosis and prognostication rely on invasive bone marrow examinations that may not capture biological heterogeneity across different disease sites. There is a clinical need for non-invasive biomarkers that can accurately [...] Read more.
Background/Objectives: Multiple myeloma (MM) is an incurable plasma cell neoplasm in which diagnosis and prognostication rely on invasive bone marrow examinations that may not capture biological heterogeneity across different disease sites. There is a clinical need for non-invasive biomarkers that can accurately predict treatment outcomes. Methods: We performed a global proteomic profiling of bone marrow-derived extracellular vesicles (EVs) from nine MM patients and ten controls. A total of 8839 proteins were identified, of which 14 met predefined selection criteria. These candidates were quantified in serum-derived EVs using targeted proteomic analysis. Prognostic relevance of selected proteins was evaluated in newly diagnosed MM (NDMM) patients treated with daratumumab-containing frontline regimens (n = 26) and healthy individuals (n = 60). Progression-free survival (PFS) was analyzed using univariable and multivariable models. Results: IL5RA (p = 0.003) and BCMA (p < 0.001) were significantly elevated in serum EVs from MM patients compared with controls. Higher serum EV-IL5RA and EV-BCMA were associated with a trend toward shorter PFS. Combined assessment of these biomarkers enabled clear stratification of MM patients into three prognostic groups, including a cohort with markedly inferior outcomes, with a 20-month PFS of 0 (p = 0.001). In multivariable analysis, the combined serum EV-IL5RA and EV-BCMA signature suggests an independent prognostic potential (HR = 38.49 [95% CI, 1.51–47.79], p = 0.015). Conclusions: Serum EV-IL5RA and EV-BCMA are novel non-invasive biomarkers, measurable through routine blood testing, with strong potential to improve risk stratification in NDMM patients in the era of daratumumab-based frontline therapy. Full article
(This article belongs to the Special Issue Advances in Exosomes and Cancer Biomarkers)
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21 pages, 2674 KB  
Article
Exosomal Thomsen–Friedenreich Glycoantigen as a Sensitive and Specific Biomarker for Colon, Ovarian and Prostate Cancer Diagnosis
by Yafei Su, Man Qi, Shoaib Vasini, Mary E. Reid, Kate Rittenhouse-Olson, Grace K. Dy and Yun Wu
Cancers 2025, 17(23), 3729; https://doi.org/10.3390/cancers17233729 - 21 Nov 2025
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Abstract
Background/Objectives: The screening and diagnosis of colon, ovarian, and prostate cancers are challenged by invasive procedures and lack of effective screening tests. To address these challenges, we developed an exosome-based liquid biopsy assay that utilized a new exosomal biomarker, α-linked Thomsen–Friedenreich glycoantigen (TF-Ag-α, [...] Read more.
Background/Objectives: The screening and diagnosis of colon, ovarian, and prostate cancers are challenged by invasive procedures and lack of effective screening tests. To address these challenges, we developed an exosome-based liquid biopsy assay that utilized a new exosomal biomarker, α-linked Thomsen–Friedenreich glycoantigen (TF-Ag-α, Galβ1-3GalNAc-α). This assay provides a minimally invasive method with high sensitivity and specificity for the screening and diagnosis of colon, ovarian and prostate cancers. Methods: Exosomal TF-Ag-α levels in 10 μL serum samples were measured using a compact, surface plasmon resonance-based biosensor developed to facilitate clinical translation. The diagnostic performance of exosomal TF-Ag-α was initially evaluated in a training set consisting of normal controls (n = 80) and cancer patients (n = 120, 40 for prostate, 40 for colon, and 40 for ovarian cancer), and then validated in an independent test set including normal controls (n = 29) and cancer patients (n = 60, 20 for each cancer type). Receiver operating characteristic (ROC) analysis was performed to assess diagnostic sensitivity, specificity and area under the curve (AUC) of exosomal TF-Ag-α. Results: Serum samples from cancer patients showed significantly elevated levels of exosomal TF-Ag-α compared with normal controls. Exosomal TF-Ag-α distinguished all cancer patients from normal controls with a sensitivity of 99.2%, specificity of 100% and an overall accuracy of 99.5% at a cutoff value of 0.406. Conclusions: These findings demonstrated the clinical translational promise of exosomal TF-Ag-α as a liquid biopsy biomarker for the detection of colon, ovarian and prostate cancers. Full article
(This article belongs to the Special Issue Advances in Exosomes and Cancer Biomarkers)
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Review

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26 pages, 5389 KB  
Review
Potential Role of Exosomes in the Pathogenesis, Diagnosis, and Treatment of Ovarian Cancer
by Anna Markowska, Michał Antoszczak, Janina Markowska and Adam Huczyński
Cancers 2026, 18(11), 1690; https://doi.org/10.3390/cancers18111690 - 22 May 2026
Abstract
Ovarian cancer (OC) remains one of the most lethal gynaecological malignancies, which is mainly due to late diagnosis, high frequency of metastasis, and the risk of developing resistance to systemic therapy. In recent years, exosomes—small extracellular vesicles (EVs) secreted by cancer cells and [...] Read more.
Ovarian cancer (OC) remains one of the most lethal gynaecological malignancies, which is mainly due to late diagnosis, high frequency of metastasis, and the risk of developing resistance to systemic therapy. In recent years, exosomes—small extracellular vesicles (EVs) secreted by cancer cells and components of the tumour microenvironment (TME)—have been identified as potential mediators of OC progression. Exosomes participate in intercellular communication and enable the transfer of RNA, proteins, and lipids. These vesicles may modulate the immune response, promote angiogenesis, remodel the extracellular matrix, and drive epithelial–mesenchymal transitions. Exosomes also appear to play a role in the development of drug resistance via direct transfer of resistance factors or indirect modification of TME. In this review article, we summarise current knowledge on the biological role of exosomes in OC pathogenesis. We also discuss their possible diagnostic, prognostic, and therapeutic relevance. The properties and composition of exosomes make them promising noninvasive liquid biomarkers and convenient carriers for anticancer drugs. However, to fully exploit their potential, further large-scale preclinical and clinical studies are required, which should focus primarily on standardising research methods and assessing the safety and efficacy of exosome-based diagnostic and therapeutic methods. Full article
(This article belongs to the Special Issue Advances in Exosomes and Cancer Biomarkers)
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