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CSC-derived exosomes regulate surrounding stromal cells in the complex TME. CSCs can regulate other microenvironmental cells through releasing exosomes carrying CSC-specific DNA, RNA, lipids, metabolites, and cytosolic and cell-surface proteins, which enhance cancer cell proliferation, modify endothelial cells to promote vascular leakiness, and regulate T cells, macrophages, and neutrophils to suppress cancer immunity and activate CAFs to promote EMT [60, 102–106]
