Extracellular vesicles in triple-negative breast cancer: Current updates, challenges and future Prospects

Prashant Kumar Tiwari ¹ Anis Ahmad Chaudhary ² Mandeep Chouhan ¹ Dr Saurabh Gupta ³ Himanshu Narayan Singh ⁴ Sarvesh Rustagi ⁵ Salah-Ud-Din Khan ⁶ Sanjay Kumar ^1,7*

• ¹ Biological and Bio-computational Lab, Department of Life Sciences, School of Basic Science and Research, Sharda University, Greater Noida, Uttar Pradesh, India
• ² Department of Biology, College of Science, Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
• ³ Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India
• ⁴ Department of Systems Biology, Columbia University Irving Medical Center, New York, NY 10032, USA, New York, United States
• ⁵ School of Applied and Life science, Uttaranchal University, Dehradun 248007, Uttarakhand, India, Dehradun, India
• ⁶ Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), 11432 Riyadh, Saudi Arabia, Riyadh, Saudi Arabia
• ⁷ Sharda University, Greater Noida, India

Breast cancer (BC) remains a complex and widespread problem, affecting millions of women worldwide, Among the various subtypes of BC, triple-negative breast cancer (TNBC) is particularly challenging, representing approximately 20% of all BC cases, and the survival rate of TNBC patients is generally worse than other subtypes of BC. TNBC is a heterogeneous disease characterized by lack of expression of three receptors: estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2), resulting conventional hormonal therapies are ineffective for its management. Despite various therapeutic approaches have been explored, but no definitive solution has been found yet for TNBC. Current treatments options are chemotherapy, immunotherapy, radiotherapy and surgery, although, these therapies have some limitations, such as the development of resistance to anticancer drugs, and off-target toxicity, which remain primary obstacles and significant challenges for TNBC. Several findings have shown that EVs exhibit significant therapeutic promise in many diseases, and a similar important role has been observed in various types of tumor. Studies suggest that EVs may offer a potential solution for the management of TNBC. This review highlights the multifaceted roles of EVs in TNBC, emphasizing their involvement in disease progression, diagnosis and therapeutic approach, as well as their potential as biomarkers and drug delivery.