Exosomes represent extracellular vesicles of endocytic origin ranging from 30 to 100 nm that are released by most of eukaryotic cells and can be found in body fluids. These vesicles in carrying DNA, RNA, microRNA (miRNA), Long noncoding RNA, proteins, and lipids serve as intercellular communicators. Due to their role in crosstalk between tumor cells and mesenchymal stroma cells, they are vital for tumor growth, progression, and anticancer drug resistance. Lung cancer is a global leading cause of cancer-related deaths with 5-year survival rates of about 7% in patients with distant metastasis. Although the implementation of targeted therapy has improved the clinical outcome of nonsmall cell lung cancer, drug resistance remains a major obstacle. Lung tumor-derived exosomes (TDEs) conveying molecular information from tumor cells to their neighbor cells or cells at distant sites of the body activate the tumor microenvironment (TME) and facilitate tumor metastasis. Exosomal miRNAs are also considered as noninvasive biomarkers for early diagnosis of lung cancer. This review summarizes the influence of lung TDEs on the TME and metastasis. Their involvement in targeted therapy resistance and potential clinical applications are discussed. Additionally, challenges encountered in the development of exosome-based therapeutic strategies are addressed.

中文翻译：

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肿瘤衍生的外泌体：非小细胞肺癌转移的关键参与者及其对靶向治疗的意义

外泌体代表由大多数真核细胞释放的 30 到 100 nm 的内吞来源的细胞外囊泡，可以在体液中找到。这些携带 DNA、RNA、microRNA (miRNA)、长链非编码 RNA、蛋白质和脂质的囊泡充当细胞间通讯器。由于它们在肿瘤细胞和间充质基质细胞之间的串扰中的作用，它们对肿瘤生长、进展和抗癌药物耐药性至关重要。肺癌是全球癌症相关死亡的主要原因，远处转移患者的 5 年生存率约为 7%。尽管靶向治疗的实施改善了非小细胞肺癌的临床结果，但耐药性仍然是主要障碍。肺肿瘤衍生的外泌体 (TDE) 将分子信息从肿瘤细胞传递到其邻近细胞或身体远处部位的细胞，激活肿瘤微环境 (TME) 并促进肿瘤转移。外泌体 miRNA 也被认为是肺癌早期诊断的非侵入性生物标志物。本综述总结了肺 TDEs 对 TME 和转移的影响。讨论了他们参与靶向治疗耐药性和潜在的临床应用。此外，还解决了在开发基于外泌体的治疗策略中遇到的挑战。本综述总结了肺 TDEs 对 TME 和转移的影响。讨论了他们参与靶向治疗耐药性和潜在的临床应用。此外，还解决了在开发基于外泌体的治疗策略中遇到的挑战。本综述总结了肺 TDEs 对 TME 和转移的影响。讨论了他们参与靶向治疗耐药性和潜在的临床应用。此外，还解决了在开发基于外泌体的治疗策略中遇到的挑战。