Pivotal role of exosomes in diagnosis and treatment of esophageal cancer in a new era of precision medicine

Core Tip

Core Tip: Esophageal cancer (EC) is a global health concern ranking seventh in incidence and sixth in mortality worldwide, with over 604000 new cases and 544000 deaths in 2020. Despite advancements in therapies, nearly half of EC patients experience distant metastasis or therapeutic resistance, resulting in a 5-year survival rate below 25%. Traditional screening methods are limited, necessitating the need for non-invasive alternatives. Liquid biopsy, particularly focusing on exosomes, emerges as a promising option for early EC detection. Exosomes, small vesicles for intercellular communication, carry diverse biomarkers and play a crucial role in tumorigenesis. Notably, exosomal microRNAs, long non-coding RNAs, and circular RNAs show potential as diagnostic and prognostic markers for esophageal squamous cell carcinoma. Beyond diagnosis, exosomes serve as effective delivery tools for therapeutic agents, exhibiting advantages in immunotherapy, gene therapy, and drug delivery, presenting a multifaceted approach in the battle against EC.