Functions of TDEs in cancer metastasis. TDEs can increase the permeability of blood vessels, which means that cancer cells are more likely to pass through blood vessels and seed in organs. TDEs can also recruit fibroblasts and immune cells, leading to matrix remodeling, causing upregulation of MMP and PN, forming a pre-metastatic niche and promoting tumor metastasis. TDE, tumor derived exosome; miR, microRNA; MMP, matrix metalloproteinase; SOX2ot, SRY-related high-mobility-group box protein-2 overlapping transcript; CAF, cancer-associated fibroblast; MDSC, myeloid-derived suppressor cell; DC, dendritic cell; TAM, tumor-associated macrophage; TAN, tumor associated neutrophil; CCL2, cell chemokine ligand 2; TGF-β, transforming growth factor β; IL, interleukin; PD-L1, programmed death ligand 1; PN, periostin.