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Some circular RNAs (circRNAs) are enriched in cancer cell\u2010derived exosomes, but little is known about their ability to regulate intercellular communication and cancer metastasis. Here, by systematically analyzing exosomes secreted by non\u2010small cell lung cancer (NSCLC) cells, a hypoxia\u2010induced exosomal circPLEKHM1 is identified that drives NSCLC metastasis through polarizing macrophages toward to M2 type. Mechanistically, exosomal circPLEKHM1 promoted PABPC1\u2010eIF4G interaction to facilitate the translation of the oncostatin M receptor (OSMR), thereby promoting macrophage polarization for cancer metastasis. Importantly, circPLEKHM1\u2010targeted therapy significantly reduces NSCLC metastasis in vivo. circPLEKHM1 serves as a prognostic biomarker for metastasis and poor survival in NSCLC patients. This study unveils a new circRNA\u2010mediated mechanism underlying how cancer cells crosstalk with macrophages within the hypoxic tumor microenvironment to promote metastasis, highlighting the importance of exosomal circPLEKHM1 as a prognostic biomarker and therapeutic target for lung cancer metastasis.<\/jats:p>","DOI":"10.1002\/advs.202309857","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T03:44:23Z","timestamp":1710992663000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Hypoxic Exosomal circPLEKHM1\u2010Mediated Crosstalk between Tumor Cells and Macrophages Drives Lung Cancer Metastasis"],"prefix":"10.1002","volume":"11","author":[{"given":"Dongliang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine Cancer Institute Fudan University Shanghai Cancer Center  Shanghai 200032 P. R. 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