Fig. 2.

EVs in the tumor microenvironment. Tumor cells secrete EVs that target the immune system. Monocytes that uptake tumor EVs are driven toward an M2 and tumor-associated phenotype, resulting in the secretion of immunosuppressive and tumor-supportive factors. Tumor-associated macrophages release EVs that also act on tumor cells, notably through activation of P13K-AKT and Wnt signaling, causing enhanced migration and proliferation. Additionally, tumor cells evade immune surveillance by shedding EVs that contain PD-L1, which directly inhibits the T cell-mediated immune response