Extracellular vesicles: Emerging modulators of cancer drug resistance

Fabrizio Fontana*, Emanuela Carollo, Genevieve E Melling, David RF Carter*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Extracellular vesicles (EVs) have recently emerged as crucial modulators of cancer drug resistance. Indeed, it has been shown that they can directly sequester anti-tumor drugs, decreasing their effective concentration at target sites. Moreover, they facilitate the horizontal transfer of specific bioactive cargoes able to regulate proliferative, apoptotic, and stemness programs in recipient cells, potentially conferring a resistant phenotype to drug-sensitive cancer cells. Finally, EVs can mediate the communication between the tumor and both stromal and immune cells within the microenvironment, promoting treatment escape. In this context, clarifying the EV-driven resistance mechanisms might improve not only tumor diagnosis and prognosis but also therapeutic outcomes. Detailed cellular and molecular events occurring during the development of EV-mediated cancer drug resistance are described in this review article.
Original languageEnglish
Article number749
Number of pages16
Issue number4
Publication statusPublished - 11 Feb 2021


  • extracellular vesicles
  • cancer drug resistance
  • chemotherapy
  • MDR transporters
  • miRNAs
  • tumor microenvironment
  • cancer stem cells


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