Extracellular Vesicles in Pancreatic Cancer Function and Potential Clinical Applications

Pancreatic cancer (PC) is one of the most aggressive gastrointestinal malignancies, characterized by a dismal 5-year survival rate. This poor prognosis is primarily attributed to delayed early detection, rapid disease progression, surgical complexities, and the limited efficacy of conventional oncological therapies. Extracellular vesicles (EVs) are nanoscale, cell-secreted vesicles that transport bioactive cargoes, including nucleic acids, proteins, and lipids. Upon release into the extracellular space, EVs facilitate short and long-distance intercellular communication and molecular transport via multiple pathways. In this review, we elucidate the multifaceted roles of EVs within the highly malignant PC microenvironment, specifically focusing on their mediation of intricate crosstalk between tumor and stromal cells. Furthermore, we summarize potential EV-based biomarkers for PC diagnosis and the recent advances in leveraging EVs as therapeutic platforms across radiotherapy, gene therapy, and immunotherapy. Ultimately, this review aims to provide novel insights into the clinical management of PC to improve patient outcomes and quality of life.