Extracellular Vesicles in Sarcoma: Implications for Tumor Progression and Therapy

Sarcoma, a heterogeneous group of malignancies arising from mesenchymal tissues, poses significant clinical challenges due to its aggressive behavior, early metastasis, and resistance to conventional therapies. Recent advancements highlight the pivotal role of extracellular vesicles (EVs)-nanoscale particles secreted by tumor and stromal cells-in modulating sarcoma progression through intercellular communication within the tumor microenvironment. This review comprehensively examines the multifaceted functions of EVs in sarcoma pathogenesis, focusing on their subtype-specific mechanisms (eg, osteosarcoma, liposarcoma) in promoting epithelial-mesenchymal transition (EMT), angiogenesis, and immune evasion. Additionally, we discuss the emerging potential of EVs as non-invasive biomarkers for early diagnosis and prognosis, as well as their engineered applications in targeted drug delivery and immunotherapy. By integrating cutting-edge research, this article underscores the translational value of EVs in overcoming current therapeutic limitations and provides a roadmap for future investigations into EV-based precision strategies for sarcoma management.