Extracellular Vesicular miRNA in Pancreatic Cancer: From Lab to Therapy.

Simple Summary: The elusive nature of pancreatic cancer frequently results in late diagnoses, which in turn leads to unfavorable treatment outcomes. The existing screening methods lack reliability, and conventional treatments demonstrate limited efficacy. Recent studies have revealed that pancreatic cancer cells interact with their surroundings, specifically through small particles called extracellular vesicles (EVs). These EVs, secreted from cells, carry important molecules, such as miRNAs, proteins, mRNAs, and lipids, that influence cancer growth, metastasis, and response to treatment. Understanding this intercellular communication among cells and microenvironment may help to find a new potential target for novel therapeutic strategies. Pancreatic cancer is a prevalent lethal gastrointestinal cancer that generally does not show any symptoms until it reaches advanced stages, resulting in a high mortality rate. People at high risk, such as those with a family history or chronic pancreatitis, do not have a universally accepted screening protocol. Chemotherapy and radiotherapy demonstrate limited effectiveness in the management of pancreatic cancer, emphasizing the urgent need for innovative therapeutic strategies. Recent studies indicated that the complex interaction among pancreatic cancer cells within the dynamic microenvironment, comprising the extracellular matrix, cancer-associated cells, and diverse immune cells, intricately regulates the biological characteristics of the disease. Additionally, mounting evidence suggests that EVs play a crucial role as mediators in intercellular communication by the transportation of different biomolecules, such as miRNA, proteins, DNA, mRNA, and lipids, between heterogeneous cell subpopulations. This communication mediated by EVs significantly impacts multiple aspects of pancreatic cancer pathogenesis, including proliferation, angiogenesis, metastasis, and resistance to therapy. In this review, we delve into the pivotal role of EV-associated miRNAs in the progression, metastasis, and development of drug resistance in pancreatic cancer as well as their therapeutic potential as biomarkers and drug-delivery mechanisms for the management of pancreatic cancer. [ABSTRACT FROM AUTHOR]