Advances in understanding exosomes-mediated tumor chemoresistance

Chemotherapy plays an essential role in controlling tumor growth and progression. However, long-term use of chemotherapeutic drugs usually results in drug resistance in tumor cells, leading to treatment failure and disease progression. The mechanism of tumor resistance to chemotherapy and the strategy of prevention or reversal of such resistance have always been hot issues in cancer therapy research. Exosomes are small spherical vesicles secreted by cells with a diameter of 40-100 nm. They carry a variety of bioactive small molecules (including DNA, ncRNA, RNA, and proteins) and participate in regulation of cell microenvironment, thereby affecting a variety of physiological and pathological activities in the body. In recent years, studies have shown that exosomes play an important role in cancer cell resistance to chemotherapy, metastasis, and immune escape. This article reviews the role and mechanism of exosomes in the development of drug resistance in tumors, and aims to provide new ideas for the prevention or treatment of tumor resistance.