# Extracellular Vesicles and Artificial Intelligence: Unique Weapons against Breast Cancer
## 2 EVs in Breast Cancer
### Exosomes as a Weapon in Precision Medicine
\begin{table}
\begin{tabular}{c c c c c} \hline \hline \multicolumn{5}{c}{**Diagnosis**} \\ \hline \multicolumn{5}{c}{**Biomarkers**} \\ \hline
**Markers** & **Expression** & **Source** & **Ref.** \\ \hline EDIL3 & \(\uparrow\) & Cells & [91] \\ \hline FN & \(\uparrow\) & Cells/plasma & [92] \\ \hline FAK & \(\uparrow\) & Plasma & [93] \\ \hline MEK1 & \(\uparrow\) & Plasma & [93] \\ \hline CD47 & \(\downarrow\) & serum & [94] \\ \hline GPC-1 & \(\uparrow\) & Cells & [95] \\ \hline GLUT-1 & \(\uparrow\) & Cells & [95] \\ \hline ADAM10 & \(\uparrow\) & Cells & [95] \\ \hline EpCAM & \(\uparrow\) & Cells/plasma & [96] \\ \hline HER2 & \(\uparrow\) & Cells/plasma & [96; 97; 98] \\ \hline RALGAPA2, PKG1 \& TJP2 & \(\uparrow\) & Plasma & [99] \\ \hline LY6G6F, VWF, BSG, & & & \\ C1 QA \& \(\uparrow\) & Plasma & [100] \\ ANGPT1/Ang1 & & & & \\ \hline Glycoprotein 130 & \(\uparrow\) & Cells & [101] \\ \hline CD147 & \(\uparrow\) & Serum & [102] \\ \hline \multicolumn{5}{c}{**Prognosis**} \\ \hline \multicolumn{5}{c}{**Biomarkers**} \\ \hline
**Markers** & **Expression** & **Source** & **Ref.** \\ \hline Annexin A2 & \(\uparrow\) & Cells/serum & [115] \\ \hline NGF & \(\uparrow\) & Serum & [116] \\ \hline IGFR\(\beta\) & \(\uparrow\) & Plasma & [92] \\ \hline CD82 & \(\uparrow\) & Serum & [117] \\ \hline Del-1 & \(\uparrow\) & Plasma & [118] \\ \hline Surivivin & \(\uparrow\) & Serum & [119] \\ \hline MMP-1/CD63 & \(\uparrow\) & Urine & [120] \\ \hline \hline \end{tabular}
\begin{tabular}{c c c c c} \hline \multicolumn{5}{c}{**miRNA**} \\ \hline
**miRNA** & **Expression** & **Source** & **Ref.** \\ \hline miR-21 & \(\uparrow\) & Plasma & [106; 107] \\ \hline miR-383-3p & \(\uparrow\) & Serum & [121] \\ \hline miR-124-3p & \(\uparrow\) & Serum & [121] \\ \hline miR-340-5p & \(\uparrow\) & Serum & [121] \\ \hline miR-290-3p & \(\uparrow\) & Serum & [121] \\ \hline miR-205-p & \(\uparrow\) & Serum & [121] \\ \hline miR-184-3p & \(\uparrow\) & Plasma & [122] \\ \hline miR-373 \& \(\uparrow\) & Plasma & [123] \\ \hline miR-5488-5p & \(\downarrow\) & Plasma & [123] \\ \hline miR-376b-5p & \(\downarrow\) & Plasma & [123] \\ \hline miR-421, miR-128-1 \& \(\uparrow\) & Serum & [124] \\ \hline \hline \end{tabular}
\end{table} 
Table 1: miRNA and biomarkers derived from EVs implicated in BC diagnosis (a), prognosis (b), and chemoresistance (c). Thus, EVs are identified as biomarkers, support cancer immunotherapies, and can act as a drug delivery mode for therapeutic agents. In fact, EVs can be genetically engineered to express specific monoclonal antibodies on their surfaces that are able to exert a host immune system response or the delivery of specific drugs for BC treatment (doxorubicin and reverse multidrug resistance) [143]. Some authors proposed HELA-Exos, a \(\alpha\)-lactalbumin (\(\alpha\)-LA)-engineered BC-derived exosome, to form an in situ dendritic cell (DC) vaccine to boost antitumor activity by promoting the activation of conventional DCs (cDCTs) in situ and tumor-reactive CD8+ T cell responses [144]. In Table 2, we report an actual clinical trial on BC exosomes, which was updated on 19 December 2023 [145]. \begin{table}
\begin{tabular}{c c c c c} \hline  & \multicolumn{4}{c}{**Chemioresistance**} \\ \hline  & \multicolumn{2}{c}{**Biomarkers**} & \multicolumn{2}{c}{**miRNA**} & \\ \hline
**Markers** & **Expression** & **Source** & **Ref.** \\ \hline PERP, ITBI, GA52 \& & & & \\ GNA13 & & & & \\ \hline GSTP1 & \(\uparrow\) & Cells/serum & [126] \\ \hline UCHL-1 & \(\uparrow\) & Cells/serum & [127] \\ \hline TrpC5 & \(\uparrow\) & Cells/serum & [127] \\ \hline BCRP, HER2 & \(\uparrow\) & Plasma & [126] \\ \hline Annexin 6 & \(\uparrow\) & Cells & [125] \\ \hline ATPases, annexins, tubulins, integrins \& & & \\ \hline Rabs & & & \\ \hline P-gp, CD4, galectin-3 & & & \\ \& glycogenin-1 & & \\ \hline TP53 & \(\uparrow\) & Cells/plasma & [128; 129; 130; 131; 132; 133; 134] \\ \hline \end{tabular}
\end{table} 
Table 1: _Cont._