Extracellular Vesicles in Advanced Prostate Cancer: Tools to Predict and Thwart Therapeutic Resistance

SIMPLE SUMMARY: Advanced prostate cancer remains currently an important cause of cancer death. Despite the emergence of new treatments during the last decade, their efficiency is limited due to therapeutic resistance of tumor cells. Extracellular vesicles are secreted by cells and play an important role in cell–cell communications. Their content is specific to the cell that produced them, and they can be isolated from biological fluids such as blood and urine. In this review, we highlight the recent results demonstrating the impact of extracellular vesicles in the mechanisms leading to therapeutic resistance and their use to find new predictive biomarkers in order to facilitate treatment decision and personalized medicine. ABSTRACT: Prostate cancer (PCa) is the second most frequent cancer and the fifth leading cause of cancer death among men worldwide. At first, advanced PCa is treated by androgen deprivation therapy with a good initial response. Nevertheless, recurrences occur, leading to Castrate-Resistance Prostate Cancer (CRPC). During the last decade, new therapies based on inhibition of the androgen receptor pathway or taxane chemotherapies have been used to treat CRPC patients leading to an increase in overall survival, but the occurrence of resistances limits their benefits. Numerous studies have demonstrated the implication of extracellular vesicles (EVs) in different cancer cellular mechanisms. Thus, the possibility to isolate and explore EVs produced by tumor cells in plasma/sera represents an important opportunity for the deciphering of those mechanisms and the discovery of biomarkers. Herein, we summarized the role of EVs in therapeutic resistance of advanced prostate cancer and their use to find biomarkers able to predict these resistances.