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Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review)

  • Authors:
    • Haoyan Zhuang
    • Xuewen Shi
  • View Affiliations / Copyright

    Affiliations: Department of Anorectal, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong 261000, P.R. China, Department of Anorectal, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250000, P.R. China
    Copyright: © Zhuang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 21
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    Published online on: November 4, 2025
       https://doi.org/10.3892/ol.2025.15374
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Abstract

Pancreatic cancer is a malignant digestive tract tumor with a poor prognosis. It remains one of the most challenging malignancies due to difficulties in early diagnosis and the development of chemotherapy resistance in advanced stages. Mesenchymal stem cells (MSCs), a distinct type of non‑hematopoietic stem cells, play a crucial role in the tumor microenvironment owing to their unique tumor‑homing capacity and immunomodulatory properties, which are largely mediated by their derived exosomes (EXOs). EXOs derived from MSCs can regulate the growth, invasion and metastasis of pancreatic cancer through the activation of specific signaling pathways. Furthermore, they have emerged as promising drug delivery vehicles and have demonstrated potential in anti‑pancreatic cancer therapy. However, within the highly fibrotic tumor microenvironment of pancreatic cancer, the functions of MSC‑derived EXOs are complex and dualistic, exhibiting both tumor‑suppressive and tumor‑promoting effects. Understanding the precise roles of MSC‑derived EXOs in pancreatic cancer is essential for the development of effective therapeutic strategies. The present review systematically summarizes the dual regulatory mechanisms of MSC‑derived EXOs in pancreatic cancer, elucidates the key molecules and signaling pathways involved, and discusses their clinical potential as novel therapeutic targets or drug delivery systems.
View Figures

Figure 1

Biogenesis and synthesis of exosomes.
The figure was generated using Figdraw (www.figdraw.com). MVBs, multivesicular bodies; SM,
sphingomyelin; GL, glycosphingolipids; PL, phosphatidylcholine; PS,
phosphatidylserine; EXOs, exosomes; MHC, major histocompatibility
complex; HSP, heat shock proteins.

Figure 2

MSC-EXOs of different sources promote
the progression of PC. The figure was generated using Figdraw
(www.figdraw.com). EXOs, exosomes; MSCs,
mesenchymal stem cells; B-MSC-EXOs, bone marrow mesenchymal stem
cell-derived exosomes; AD-MSC-EXOs, adipose mesenchymal stem
cell-derived exosomes; UC-MSC-EXOs, umbilical cord mesenchymal stem
cell-derived exosomes; PC, pancreatic cancer; SOCS3, suppressor of
cytokine signaling 3; CBX7, chromobox protein homolog 7; DNMT, DNA
methyltransferase; miR, microRNA.

Figure 3

Therapeutic effect of MSC-EXOs of
different sources in PC. The figure was generated using Figdraw
(www.figdraw.com). EXOs, exosomes; UC-MSC-EXOs,
umbilical cord mesenchymal stem cell-derived exosomes; B-MSC-EXOs,
bone marrow mesenchymal stem cell-derived exosomes; hA-MSC-EXOs,
human amniotic mesenchymal stem cell-derived exosomes;
hAF-MSC-EXOs, human amniotic fluid mesenchymal stem cell-derived
exosomes; Dental-MSC-EXOs, dental pulp mesenchymal stem
cell-derived exosomes; PTX, paclitaxel; OXA, oxaliplatin; PC,
pancreatic cancer; miR, microRNA; DOGEM, dodecyloxybenzyl
gemcitabine; si, small interfering.

Figure 4

Surface molecules and common
functions of mesenchymal stem cells from different sources. The
molecules and inclusions carried on the surface of MSC-EXOs from
different sources vary, but they generally possess common
capabilities such as high self-replication, strong differentiation
potential, immune regulation, promote angiogenesis and tumor homing
ability. B-MSCs (64), AD-MSCs
(65–69), UC-MSCs (64), P-MSCs (70–72),
PB-MSCs (73,74). The figure was generated using
Figdraw (www.figdraw.com). B-MSCs, bone
marrow-derived mesenchymal stem cells; AD-MSCs, adipose-derived
mesenchymal stem cells; UC-MSCs, umbilical cord-derived mesenchymal
stem cells; P-MSCs, placenta-derived mesenchymal stem cells;
PB-MSCs, peripheral blood derived mesenchymal stem cells.
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Copy and paste a formatted citation
Spandidos Publications style
Zhuang H and Shi X: Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review). Oncol Lett 31: 21, 2026.
APA
Zhuang, H., & Shi, X. (2026). Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review). Oncology Letters, 31, 21. https://doi.org/10.3892/ol.2025.15374
MLA
Zhuang, H., Shi, X."Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review)". Oncology Letters 31.1 (2026): 21.
Chicago
Zhuang, H., Shi, X."Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review)". Oncology Letters 31, no. 1 (2026): 21. https://doi.org/10.3892/ol.2025.15374
Copy and paste a formatted citation
x
Spandidos Publications style
Zhuang H and Shi X: Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review). Oncol Lett 31: 21, 2026.
APA
Zhuang, H., & Shi, X. (2026). Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review). Oncology Letters, 31, 21. https://doi.org/10.3892/ol.2025.15374
MLA
Zhuang, H., Shi, X."Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review)". Oncology Letters 31.1 (2026): 21.
Chicago
Zhuang, H., Shi, X."Mesenchymal stem cell‑derived exosomes: Regulators of progression and suppression in pancreatic cancer (Review)". Oncology Letters 31, no. 1 (2026): 21. https://doi.org/10.3892/ol.2025.15374
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