Clinical Utility of Exosomal Rna in Cancer Pathology and Therapeutic Monitoring

Effective cancer monitoring remains an important clinical challenge due to tumour heterogeneity, invasiveness of the biopsy, and unavailability of real-time diagnostics. Traditional tissue biopsy largely cannot capture the dynamic molecular condition of tumours, and a critical demand exists for reproducible and non-invasive biomarkers. Exosomes—small extracellular vesicles that carry molecular cargo such as RNA—have emerged as promising candidates for liquid biopsy-based cancer diagnosis. The purpose of this research was to explore the clinical usefulness of exosomal RNAs as diagnostic and prognostic biomarkers in different types of cancer and evaluate their utility for Therapeutic monitoring and personalized oncology. An experimental model consisting of plasma and urine sampling from patients with breast, colorectal, prostate, and lung cancers was used. Exosomes were isolated using differential ultracentrifugation and immunoaffinity techniques and validated by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and western blotting. RNA was isolated, quantified with Qubit and Bioanalyzer, and analyzed by qRT-PCR and miRNA arrays. Bioinformatics and statistical analysis were performed to evaluate expression patterns, diagnostic and prognostic associations, and concordance. Cancer- specific exosomal RNA signatures were identified with the remarkable upregulation of miR-21, miR-1246, miR-141, and miR-200c. Exosomes from plasma gave superior RNA quality and quantity than urine samples. Individual miRNAs were over 85% sensitive and specific for diagnosis, and increased levels were significantly associated with decreased progression-free survival. Exosomal RNAs offer a highly efficient, minimally invasive means of cancer diagnosis, prognosis, and monitoring. Their integration into the clinic can help in the early detection, personalization of treatment strategies, and improvement of patient outcomes in precision oncology.