{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:49:04Z","timestamp":1791319744617,"version":"4.3.1"},"reference-count":192,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T00:00:00Z","timestamp":1737158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Prostate cancer, a leading cause of cancer-related mortality among men, often presents challenges in accurate diagnosis and effective monitoring. This systematic review explores the potential of exosomal biomolecules as noninvasive biomarkers for the diagnosis, prognosis, and treatment response of prostate cancer. A thorough systematic literature search through online public databases (Medline via PubMed, Scopus, and Web of science) using structured search terms and screening using predefined eligibility criteria resulted in 137 studies that we analyzed in this systematic review. We evaluated the findings from these clinical studies, revealing that the load of exosomes in the blood and urine of prostate cancer patients, which includes microRNAs (miRNAs), proteins, and lipids, demonstrates disease-specific changes. It also shows that some exosomal markers can differentiate between malignant and benign hyperplasia of the prostate, predict disease aggressiveness, and monitor treatment efficacy. Notably, miRNA emerged as the most frequently studied biomolecule, demonstrating superior diagnostic potential compared to traditional methods like prostate-specific antigen (PSA) testing. The analysis also highlights the pressing need for a standardised analytic approach through multi-centre studies to validate the full potential of exosomal biomarkers for the diagnosis and monitoring of prostate cancer.<\/jats:p>","DOI":"10.3390\/ijms26020802","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T06:53:32Z","timestamp":1737442412000},"page":"802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Exosomal Liquid Biopsy in Prostate Cancer: A Systematic Review of Biomarkers for Diagnosis, Prognosis, and Treatment Response"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0948-7746","authenticated-orcid":false,"given":"Yameen","family":"Hamid","sequence":"first","affiliation":[{"name":"The University of Edinburgh, Edinburgh EH8 9YL, UK"},{"name":"Department of Acute Medicine, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6662-9504","authenticated-orcid":false,"given":"Rukhshana Dina","family":"Rabbani","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9320-2693","authenticated-orcid":false,"given":"Rakkan","family":"Afsara","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Evercare Hospital, Dhaka 1205, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samarea","family":"Nowrin","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone ME16 9QQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-8033","authenticated-orcid":false,"given":"Aruni","family":"Ghose","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Department of Urology, Kent and Canterbury Hospital, Canterbury CT1 3NG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0847-8880","authenticated-orcid":false,"given":"Konstantinos","family":"Sirlantzis","sequence":"additional","affiliation":[{"name":"School of Engineering, Technology and Design, Canterbury Christ Church University, Canterbury CT1 1QU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9522-4159","authenticated-orcid":false,"given":"Saak V.","family":"Ovsepian","sequence":"additional","affiliation":[{"name":"Faculty of Engineering and Science, University of Greenwich London, Chatham Maritime, Kent ME4 4TB, UK"},{"name":"Faculty of Medicine, Tbilisi State University, Tbilisi 0177, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-6131","authenticated-orcid":false,"given":"Stergios","family":"Boussios","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"},{"name":"Faculty of Medicine, Health, and Social Care, Canterbury Christ Church University, Canterbury CT2 7PB, UK"},{"name":"School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, Strand, London WC2R 2LS, UK"},{"name":"Kent and Medway Medical School, University of Kent, Canterbury CT2 7LX, UK"},{"name":"AELIA Organisation, 9th km Thessaloniki\u2014Thermi, 57001 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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