Extracellular Vesicle-Based Liquid Biopsies: Decoding the Tumor Microenvironment for Precision Oncology

Year : 2026 | Volume : 15 | Issue : 01 | Page : 43 62
    By

    Shubham Sah,

  • Deepa Kumari,

  • Manish Kumar,

  • Meghana Inupamula,

  • Abhay Kumar Yadav,

  • Mohan Mishra,

  • Abhijeet Pandey,

  1. Student, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER), Thiruvananthapuram, Kerala, India
  2. Student, Department of Biochemistry, Central University of Haryana, Mahendragarh, Haryana, India
  3. Student, Department of Public Health, University of Hyderabad, Hyderabad, Telangana, India
  4. Student, Department of Public Health, University of Hyderabad, Hyderabad, Telangana, India
  5. Student, Department of Biotechnology, Indira Gandhi National Tribal University, Amarkantak, Madhya Pradesh, India
  6. Student, Department of Biotechnology, Gujarat Biotechnology University, Gandhinagar, Gujarat, India
  7. Student, Department of Biomedical Sciences, Central University of Haryana, Mahendragarh, Haryana, India

Abstract

The tumor microenvironment (TME) plays a pivotal role in cancer initiation, progression, and therapeutic response. Decoding the TME is, therefore, essential for advancing precision oncology. Extracellular vesicles (EVs), including exosomes and microvesicles, are nanoscale lipid bilayer particles secreted by tumor and stromal cells. They transport a wide range of bioactive molecules, such as DNA, RNA, proteins, lipids, and metabolites, which reflect the dynamic state of the TME. Recent advances in liquid biopsy have highlighted EVs as promising, minimally invasive biomarkers for cancer diagnosis, prognosis, and therapy monitoring. Unlike traditional tissue biopsies, EV-based liquid biopsies provide a real-time snapshot of tumor biology and can capture spatial and temporal heterogeneity. In this review, we critically evaluate the role of EV-derived biomarkers in immune modulation, angiogenesis, metastasis, and therapy resistance within the TME. We also summarize emerging EV isolation and characterization technologies, ranging from ultracentrifugation to microfluidic and nano-plasmonic platforms. Current challenges are addressed, including assay standardization, vesicle heterogeneity, and clinical validation. Looking ahead, the integration of EV-based liquid biopsy with multi-omics profiling and artificial intelligence has the potential to accelerate translation into clinical oncology. By bridging molecular pathology with translational research, EV-derived biomarkers may provide powerful tools for early detection, patient stratification, and precision-guided therapies. This review emphasizes the transformative potential of EV-based liquid biopsies in decoding the TME and shaping the future of personalized cancer management.

Keywords: Cancer biomarkers, Exosomes, Extracellular vesicles, Immune modulation, Liquid biopsy, Metastasis, Microfluidics, Multiomics, Nano-diagnostics, Precision oncology, Therapy resistance, Tumor/Tumour microenvironment

[This article belongs to Research and Reviews: Journal of Oncology and Hematology ]

How to cite this article:
Shubham Sah, Deepa Kumari, Manish Kumar, Meghana Inupamula, Abhay Kumar Yadav, Mohan Mishra, Abhijeet Pandey. Extracellular Vesicle-Based Liquid Biopsies: Decoding the Tumor Microenvironment for Precision Oncology. Research and Reviews: Journal of Oncology and Hematology. 2026; 15(01):43-62.
How to cite this URL:
Shubham Sah, Deepa Kumari, Manish Kumar, Meghana Inupamula, Abhay Kumar Yadav, Mohan Mishra, Abhijeet Pandey. Extracellular Vesicle-Based Liquid Biopsies: Decoding the Tumor Microenvironment for Precision Oncology. Research and Reviews: Journal of Oncology and Hematology. 2026; 15(01):43-62. Available from: https://journals.stmjournals.com/rrjooh/article=2026/view=241140


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Regular Issue Subscription Review Article
Volume 15
Issue 01
Received 21/01/2026
Accepted 04/02/2026
Published 05/04/2026
Publication Time 74 Days
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