Figure 3.

Extracellular vesicle miRNAs are responsible for therapeutic resistance. Exosomes and microvesicles (EVs), derived from cancer-associated cells, drug-resistant cancer cells, and cancer stem cells (CSCs), confer neighboring cells resistance to various anti-cancer treatments via transferring miRNAs, which regulate several factors associated with resistance mechanisms. Rounded rectangles represent miRNAs (light green), miRNA targets (orange), and signaling factors/cellular events affected by miRNA targets (light orange). Activation is indicated by solid line arrows, and inhibitory effects are demonstrated by perpendicular lines. The secretion of extracellular vesicles is denoted by dashed arrows. Potential mechanisms underlying the role of extracellular vesicle miRNAs in therapeutic resistance are explained in Section 7.