Extracellular Vesicles in Lung Cancer Metastasis and Their Clinical Applications

Cancer cells are known to interact with the surrounding extracellular environment to facilitate tumorigenic processes. One mechanism by which cancer cells communicate with each other and their environment is through extracellular vesicles. These vesicles contain various biological molecules that are secreted by parental cells for delivery to target recipient cells. Over the past several decades, knowledge of the structure and contents of extracellular vesicles has provided valuable insight into tumor biology. Considering this information, researchers have begun examining the potential of these vesicles for developing novel biomarker classifiers as well as therapeutic strategies. Extracellular vesicles (EVs) are heterogenous membrane-encapsulated vesicles secreted by every cell into the extracellular environment. EVs carry bioactive molecules, including proteins, lipids, DNA, and different RNA forms, which can be internalized by recipient cells, thus altering their biological characteristics. Given that EVs are commonly found in most body fluids, they have been widely described as mediators of communication in several physiological and pathological processes, including cancer. Moreover, their easy detection in biofluids makes them potentially useful candidates as tumor biomarkers. In this manuscript, we review the current knowledge regarding EVs and non-coding RNAs and their role as drivers of the metastatic process in lung cancer. Furthermore, we present the most recent applications for EVs and non-coding RNAs as cancer therapeutics and their relevance as clinical biomarkers.