Extracellular derived-exosomal micrornas in pancreatic cancer: investigating their diagnostic importance and potential targets for the prevention and treatment in pancreatic cancer

Pancreatic cancer stands out as a deadly disease because patients receive late diagnosis and struggle with ineffective treatments. Exosomal microRNAs (miRNAs) that exist inside lipid bilayers help tumors grow and spread while making cells resistant to treatment and enabling cell-to-cell communication. Their ability to stay stable in body fluids makes them good candidates for early disease detection and treatment prediction tests. Research shows that miR-21, miR-17-5p, and miR-155 exosomal miRNAs help pancreatic cancer progress but also provide new targets for medical treatment. This review consolidates current evidence on the diagnostic, prognostic, and therapeutic potential of exosomal miRNAs in pancreatic cancer, integrating mechanistic insights into key signaling pathways such as PTEN/PI3Kγ, KRAS/MAPK, and TGF-β. Compared with previous reports, this work provides a comparative framework linking disease-specific exomiR profiles to other cancers, highlighting miR-21, miR-17-5p, miR-155, and miR-301a as central modulators. We further discuss methodological challenges, translational opportunities, and future directions in developing exosome-based diagnostics and miRNA-loaded therapeutic platforms. Understanding exosomal miRNA networks can pave the way for precision detection and targeted therapy in pancreatic cancer.