Dual role of exosomes in pancreatic cancer: Underlying mechanisms and research advances (Review).

Pancreatic cancer is one of the most common malignant tumors. Due to late diagnosis and a lack of effective treatments, pancreatic cancer has a poor prognosis and a high mortality rate. Further understanding of the mechanisms underlying the development and progression of pancreatic cancer is key to developing rational diagnostic and therapeutic strategies. Exosomes are small vesicles secreted by most cells, carrying a rich cargo of lipids, proteins and nucleic acids. Exosomes serve various roles in intercellular communication, biological processes and signal transduction. Notably, exosomes exhibit a dual role in pancreatic cancer: Exosomes can directly promote tumor cell proliferation, growth and metastasis, modulate the complex immunosuppressive microenvironment and contribute to chemoresistance; by contrast, exosomes can serve as biomarkers for diagnosis and drug delivery vehicles. The present study systematically reviewed the mechanisms through which exosomes exert their dual functions via their specific biomolecular cargo in pancreatic cancer, as well as their potential applications in diagnosis and treatment, thereby laying a research foundation for exosomes to potentially serve a more active role in pancreatic cancer in the future.