Advances in Exosome Research in Renal Cell Carcinoma: Mechanisms, Biomarkers, and Therapeutic Applications.

Renal cell carcinoma (RCC) is a common malignant neoplasm of the urinary system, characterized by the difficulty of early diagnosis and the frequent emergence of therapeutic resistance in advanced stages, both of which profoundly compromise patient prognosis. Exosomes, as nanoscale vesicles secreted by cells, are capable of transporting bioactive molecules such as proteins and nucleic acids, thereby mediating communication within the tumor microenvironment and offering novel avenues for the noninvasive diagnosis and treatment of RCC. This article reviews recent advances in exosome research in RCC. It first outlines the biogenesis, structure, and biological functions of exosomes; it then systematically examines their pivotal roles in RCC invasion and metastasis, epithelial-mesenchymal transition, immune evasion, angiogenesis, and therapeutic resistance. Furthermore, it explores the potential of exosomes as biomarkers for the early diagnosis and prognostic assessment of RCC, as well as their promising applications in therapy as drug delivery vehicles and tumor vaccines. Finally, the review summarizes the current challenges confronting exosome research, including the lack of standardized isolation techniques and insufficient clinical validation, and considers future directions for promoting their clinical translation through the integration of multi-omics approaches and artificial intelligence. This review provides a theoretical foundation and valuable reference for the precise diagnosis and treatment of RCC.