The Role of Tumor-Derived Extracellular Vesicles in Drug Resistance in Urologic Cancers

In spite of the therapeutic progress achieved in the treatment of urologic tumors, the persistence and intricate nature of tumor resistance significantly impact patient prognoses. Extracellular vesicles (EVs), actively secreted by diverse cell types, assume a crucial role in facilitating intercellular communication. These EVs facilitate the transfer of functional molecules, encompassing RNA, proteins, and lipids, to recipient cells. While these molecules participate in normal physiological processes, they also play a pivotal role in the pathogenesis of various diseases. Notably in the context of cancer, numerous investigations have substantiated the involvement of tumor-derived EVs in the development of drug resistance. This review comprehensively explores the mechanisms underlying drug resistance in urologic cancers, elucidates the contributions of tumor-derived EVs to drug resistance in urologic tumors, discusses advancements in targeting EVs to mitigate drug resistance in urologic tumors, and assesses the utility of EVs as biomarkers for drug resistance in urologic tumors. Tumor cell-derived EVs-mediated intercellular communication is an enhancer of tumor drug resistance by affecting intra-tumor heterogeneous phenotype and plays a key role in urologic cancer drug resistance. image