Published online Jul 24, 2025. doi: 10.5306/wjco.v16.i7.107633
Revised: April 29, 2025
Accepted: June 20, 2025
Published online: July 24, 2025
Processing time: 117 Days and 3.4 Hours
Colorectal cancer (CRC) is a common and deadly malignancy worldwide, causing high morbidity and mortality rates. Chemoresistance continues to be the major barrier to the effective treatment of CRC. Circular RNA (circRNA), a recently identified class of non-coding RNA, has become an emerging focus in CRC research due to its abundant presence and stability in extracellular vesicles (EVs). The circRNA of EVs (EVs-circRNA) is closely associated with CRC progression and plays a pivotal role in chemoresistance mechanisms. This paper investigates the circRNA mechanism underlying different chemoresistance scenarios in CRC and explores the dual role of EVs-circRNA in mediating chemotherapy resistance. Furthermore, EVs-circRNA, a non-invasive biomarker for liquid biopsies, holds significant promise in clinical applications, ranging from early CRC diagnosis to monitoring disease progression and assessing prognosis. These studies provide a new perspective for uncovering CRC pathogenesis and lay the foundation for precision therapy and personalized treatment strategies for CRC. In the future, therapeutic strategies targeting EVs-circRNAs are anticipated to revolutionize CRC treatment, leading to improved therapeutic outcomes and enhanced quality of life for patients.
Core Tip: Colorectal cancer (CRC) chemoresistance remains a major therapeutic challenge. Circular RNA (circRNA) is enriched and stable in extracellular vesicles (EVs), drives CRC progression, and mediates drug resistance. The circRNA of EVs as a non-invasive biomarker for diagnosis, monitoring, and prognosis offers a promising strategy for precision therapy of CRC.