Cancer-derived exosomes as novel biomarkers in metastatic gastrointestinal cancer - Review - Open Access

Sep 24, 2026

Uploaded by Riley

Gastrointestinal cancer (GIC) is the most prevalent and highly metastatic malignancy, driving substantial cancer-related mortality. However, diagnostic technology has not kept pace with the evolution of detection methods, leaving a gap in innovative and efficient clinical assays for GIC. Exosomes are preferentially released by many cellular sources, especially neoplastic cells, producing cancer-enriched molecular cargo. Their widespread presence in multiple biological fluids enables non-invasive, real-time monitoring with tumor specificity, supporting exosome-based liquid biopsy for early diagnosis and prognosis of GIC metastasis. This review consolidates recent findings on cancer-derived exosomes (CDEs) in GIC, emphasizing mechanisms promoting metastasis and outlining CDE potential for biomarker and therapeutic use.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages26

Reading Time1 h 6 min

AccessFree to download

Abstract

Introduction

Epidemiology and diagnostic limitations in GIC

Exosomes as liquid biopsy biomarkers

Keywords

Zhong et al. Molecular Cancer (2024) 23:67 [https://doi.org/10.1186/s12943-024-01948-6](https://doi.org/10.1186/s12943-024-01948-6) Molecular Cancer REVIEW Open Access Cancer-derived exosomes as novel biomarkers in metastatic gastrointestinal cancer Danyang Zhong1†, Ziyuan Wang1†, Zhichao Ye1†, Yifan Wang1,2,3,4* and Xiujun Cai1,2,3,4* Abstract Gastrointestinal cancer (GIC) is the most prevalent and highly metastatic malignant tumor and has a significant impact on mortality rates. Nevertheless, the swift advancement of contemporary technology has not seamlessly aligned with the evolution of detection methodologies, resulting in a deficit of innovative and efficient clinical assays for GIC. Given that exosomes are preferentially released by a myriad of cellular entities, predominantly originating from neoplastic cells, this confers exosomes with a composition enriched in cancer-specific constituents. Furthermore, exosomes exhibit ubiquitous presence across diverse biological fluids, endowing them with the inherent advantages of non-invasiveness, real-time monitoring, and tumor specificity. The unparalleled advantages inherent in exosomes render them as an ideal liquid biopsy biomarker for early diagnosis, prognosticating the potential development of GIC metastasis. In this review, we summarized the latest research progress and possible potential targets on cancer-derived exosomes (CDEs) in GIC with an emphasis on the mechanisms of exosome promoting cancer metastasis, highlighting the potential roles of CDEs as the biomarker and treatment in metastatic GIC. Keywords Exosomes, Metastasis, Biomarker, Gastrointestinal cancer Introduction According to the latest statistical data on cancer, 1,918,030 new cases and 609,360 cancer-related deaths (CRDs) had been documented. Among them, the GIC †Danyang Zhong, Ziyuan Wang and Zhichao Ye contributed equally to this work. *Correspondence: Yifan Wang [anwyf@zju.edu.cn](anwyf@zju.edu.cn)[ ](anwyf@zju.edu.cn)Xiujun Cai[srrsh_cxj@zju.edu.cn](srrsh_cxj@zju.edu.cn) 1 Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China 2 National Engineering Research Center of Innovation and Application of Minimally Invasive Instruments, Hangzhou 310016, China 3 Zhejiang Minimal Invasive Diagnosis and Treatment Technology Research Center of Severe Hepatobiliary Disease, Hangzhou 310016, China 4 Key Laboratory of Laparoscopic Technology of Zhejiang Province, Hangzhou 310016, China ranks second but is responsible for about 28% of cancer-related deaths. Colorectal cancer (CRC) is the most prevalent GIC which accounts for 44% of all cancer cases, followed by pancreatic cancer (PC) which has a 5-year survival rate of less than 11% and is the most lethal cancer [1]. Furthermore, global GIC morbidity and mortality continue to rise [1]. Metastatic cancers are in charge of 90% of CRDs [2, 3], and metastatic GIC is characterized by high aggressiveness and heterogeneity which take primary responsibility for death in patients with malignant GIC [4]. While diverse diagnostic methods, including gastroscope, computed tomography (CT) scan, and pathological examinations [4, 5], are vital for terminal-stage cancer with conspicuous symptoms, the main challenge in GIC diagnosis stems from the restricted sensitivity of these technical approaches to small lesions in pre-metastatic GIC or residual masses post radiotherapy and chemotherapy. In addition, some methods own limitations on incursion and potential of transmission. Current © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other thi

FAQs

Why are cancer-derived exosomes considered promising biomarkers for metastatic gastrointestinal cancer?

Cancer-derived exosomes are enriched with cancer-specific constituents, are present in diverse biological fluids, and allow non-invasive, real-time monitoring with tumor specificity, supporting their use as liquid biopsy biomarkers for diagnosis and prognosis.

What diagnostic challenges exist for gastrointestinal cancer today?

Conventional approaches such as gastroscopy, computed tomography, and pathological examinations can lack sensitivity for small lesions in pre-metastatic disease and may miss residual masses after radiotherapy and chemotherapy, limiting detection performance and specificity.

What does the review focus on regarding cancer-derived exosomes in GIC?

The review summarizes recent research progress and potential targets, with emphasis on mechanisms by which cancer-derived exosomes promote GIC metastasis, and highlights their potential roles as biomarkers and therapeutic targets in metastatic GIC.

Sep 24, 2026

Uploaded by Riley