The dual roles of exosomes in prostate cancer - mechanisms in tumorigenesis and avenues for clinical translation

Sep 23, 2026

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Prostate cancer management faces major obstacles from tumor heterogeneity, unpredictable progression, and limited early detection, creating demand for deeper biological insight. Exosomes act as key intercellular communication mediators with dual functions in prostate cancer pathogenesis and treatment: they can promote EMT, angiogenesis, tumor microenvironment remodeling, metastasis, immune evasion, and therapy resistance, while also enabling diagnostic biomarkers for noninvasive liquid biopsy and engineered therapeutic delivery. This review covers exosomal biogenesis, isolation methods, and bidirectional regulation with emphasis on clinical translation.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages20

Reading Time50 min

AccessFree to download

Introduction

Exosomes in prostate cancer pathogenesis

Double-edged roles of exosomes

Diagnostic and therapeutic potential

TYPE Review PUBLISHED 11 February 2026 DOI 10.3389/fimmu.2026.1748272 OPEN ACCESS EDITED BY Guochun Zhang, Guangdong Provincial People’s Hospital, China REVIEWED BY Nagaraja Sethuraman Balakathiresan, National Institute on Alcohol Abuse and Alcoholism (NIH), United States Mahda Delshad, Shahid Beheshti University of Medical Sciences, Iran *CORRESPONDENCE Chong Zhang [peiyaogege@163.com](peiyaogege@163.com)[ ](peiyaogege@163.com)Guanghe Ran [rangg1012@163.com](rangg1012@163.com)[ ](rangg1012@163.com)RECEIVED 17 November 2025 REVISED 16 January 2026 ACCEPTED 27 January 2026 PUBLISHED 11 February 2026 CITATION Yu M, Zhou D, Wei H, Wu T, Fan J, Ran G and Zhang C (2026) The dual roles of exosomes in prostate cancer: mechanisms in tumorigenesis and avenues for clinical translation. Front. Immunol. 17:1748272 . doi: 10.3389/fimmu.2026.1748272 COPYRIGHT © 2026 Yu, Zhou, Wei, Wu, Fan, Ran and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. The dual roles of exosomes in prostate cancer: mechanisms in tumorigenesis and avenues for clinical translation Mingyun Yu 1, Dan Zhou 1, Huijie Wei 1, Tong Wu 1, Jiahong Fan 2, Guanghe Ran 3* and Chong Zhang 1* 1 Department of Pathology, Chongqing University Fuling Hospital, Chongqing, China, 2 Binhai New Area Hospital of Traditional Chinese Medicine (TCM), Fourth Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China, 3Chongqing Changshou Traditional Chinese Medicine Hospital, Chongqing, China Prostate cancer (PCa) management remains challenged by tumor heterogeneity, unpredictable progression, and limitations in early detection, driving demand for innovative biological insights. As pivotal mediators of intercellular communication, exosomes exhibit dualistic roles in PCa pathogenesis and therapy. While acting as ‘foes’ by facilitating epithelial-mesenchymal transition (EMT), angiogenesis, tumor microenvironment formation, metastasis, immune evasion, and therapy resistance, they concurrently serve as ‘friends ’ through their diagnostic and therapeutic potential. Exosome-derived biomarkers enable noninvasive liquid biopsy for early diagnosis, risk stratiﬁcation, and treatment monitoring. Moreover, engineered exosomes function as targeted drug carriers, delivering precision therapeutics to overcome treatment barriers. This review systematically examines exosomal biogenesis, isolation methodologies, and their bidirectional regulation in PCa progression, while exploring emerging diagnostic and therapeutic applications to advance exosome-mediated precision oncology. KEYWORDS cancer, clinical application, exosomes, mechanism, prostate cancer 1 Introduction Prostate cancer (PCa) ranks as the second most prevalent malignancy and ﬁfth leading cause of cancer mortality among males globally, posing a signiﬁcant clinical challenge for prevention and treatment (1) . Early-stage localized PCa can be effectively managed with surgery or radiation therapy, leading to favorable prognoses. However, once the disease progresses to advanced metastatic or castration-resistant stages (Castration-Resistant Prostate Cancer, CRPC), treatment options become signiﬁcantly limited, and patient survival is severely compromised (2) . Investigating the underlying mechanisms of PCa development, metastasis, and drug resistance is crucial for developing novel diagnostic and therapeutic strategies and improve the prognosis of patients (3) . Accumulating evidence underscores exosomes—critical intercellular mediators—as pivotal yet complex regula

FAQs

What dual roles do exosomes play in prostate cancer?

Exosomes can act as tumor-promoting “foes” by supporting EMT, angiogenesis, metastasis, immune evasion, and therapy resistance. They can also serve as “friends” by providing diagnostic biomarkers and therapeutic delivery potential.

How can exosome-derived biomarkers support prostate cancer diagnosis and monitoring?

Exosome-derived biomarkers enable noninvasive liquid biopsy, supporting early diagnosis, risk stratification, and treatment monitoring.

Which exosome functions relate to therapy resistance in prostate cancer?

The review links exosome-mediated communication to therapy resistance, including resistance affecting chemotherapy and targeted therapy outcomes.

Sep 23, 2026

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