Tracing the Scientific Evolution of Exosomal microRNA Research in Liver Cancer: A Comprehensive Review

Exosomal microRNAs (miRNAs) have emerged as critical mediators of intercellular communication, influencing numerous physiological and pathological processes. In the context of liver cancer, particularly hepatocellular carcinoma (HCC), exosomal miRNAs contribute to tumor initiation, progression, metastasis, and therapy resistance by modulating the tumor microenvironment and signaling pathways. This review comprehensively summarizes the biogenesis, functions, and physiological roles of miRNAs and their exosomal forms, highlighting their involvement in various diseases with a focus on liver cancer. We discuss the current landscape of exosomal miRNA research in HCC, examining their potential as diagnostic and prognostic biomarkers, as well as therapeutic targets. Additionally, we critically evaluate past and ongoing drug development efforts targeting exosomal miRNA pathways and emphasize existing challenges and future directions in this rapidly evolving field. Understanding the intricate roles of exosomal miRNAs in liver cancer will advance biomarker discovery and foster novel therapeutic strategies, ultimately improving patient outcomes.