Extracellular Vesicles in the Progression and Therapeutic Resistance of Nasopharyngeal Carcinoma

SIMPLE SUMMARY: The occurrence and development of nasopharyngeal carcinoma (NPC) is closely related to the Epstein–Barr virus. Extracellular vesicles (EVs) play a critical role in tumor progression. EVs in NPC, especially EV-loaded molecules with Epstein–Barr virus characteristics, can not only allow the evaluation of the malignant degree and progression of a tumor but also provide appropriate methods and monitoring means for the therapy. The present review summarizes the pivotal role of tumor-derived EVs in regulating NPC progression and therapeutic resistance. Furthermore, the bench-to-bedside translations of EVs as biomarkers in the diagnosis and precise treatments of NPC are discussed. ABSTRACT: Nasopharyngeal carcinoma (NPC) is an epithelial malignancy largely associated with Epstein–Barr virus (EBV) infection, which is frequently reported in east and southeast Asia. Extracellular vesicles (EVs) originate from the endosome or plasma membrane, which plays a critical role in tumor pathogenesis for their character of cell-cell communication and its cargos, including proteins, RNA, and other molecules that can target recipient cells and affect their progression. To date, numerous studies have indicated that EVs have crucial significance in the progression, metastasis, and therapeutic resistance of NPC. In this review, we not only summarize the interaction of NPC cells and the tumor microenvironment (TME) through EVs, but also explain the role of EVs in radiation and drug resistance of NPC, which poses a severe threat to cancer therapy. Therefore, EVs may show great potential as biomarkers in the early diagnosis of interfered targets of NPC therapy.