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. 2024 Feb 5;9:27. doi: 10.1038/s41392-024-01735-1

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 4 — The multifunctional landscape of tumor-derived extracellular vesicles in tumorigenesis. This figure provides a detailed insight into the multifunctional activities of EVs emanating from cancer cells and their role in advancing tumorigenesis. Tumor-derived EVs encapsulate diverse bioactive molecules, including miRNAs, specific cytokines, and oncogenes. These molecular constituents determine the functional role of the EVs. EVs transport growth-promoting miRNAs and oncogenes to neighboring cancer cells, fueling their uncontrolled division and expansion.The EVs instigate a transformative process in epithelial cells by delivering specific miRNAs and proteins, endowing them with mesenchymal traits that enhance mobility and invasiveness.EVs convey pro-angiogenic factors to endothelial cells, stimulating the sprouting of new blood vessels, which nourish and support the expanding tumor mass. By presenting specific immunosuppressive cytokines and miRNAs to immune cells, such as macrophages, the EVs create an environment conducive to tumor evasion from immune surveillance. The EVs actively engage with various stromal cells, notably cancer-associated fibroblasts (CAFs) and macrophages. This cellular crosstalk, mediated by EVs, reshapes the tumor milieu, promoting a supportive scaffold and immune-tolerant backdrop for cancer progression