Cancer is a complex deadly disease that has caused a
global health
crisis in recent epochs. Colorectal cancer (CRC) is the third most
common malignant gastrointestinal disease. It has led to high mortality
due to early diagnostic failure. Extracellular vesicles (EVs) come
with promising solutions for CRC. Exosomes (a subpopulation of EVs)
play a vital role as signaling molecules in CRC tumor microenvironment.
It is secreted from all active cells. Exosome-based molecular transport
(DNA, RNA, proteins, lipids, etc.) transforms the recipient cell’s
nature. In CRC, tumor cell-derived exosomes (TEXs) regulate multiple
events of CRC development and progression such as immunogenic suppression,
angiogenesis, epithelial–mesenchymal transitions (EMT), physical
changes in the extracellular matrix (ECM), and metastasis. Biofluid-circulated
tumor-derived exosomes (TEXs) are a potential tool for CRC liquid
biopsy. Exosome-based colorectal cancer detection creates a great
impact in CRC biomarker research. The exosome-associated CRC theranostics
approach is a state-of-the-art method. In this review, we address
the CRC and exosomes complex associated with cancer development and
progression, the impact of exosomes on CRC screening (diagnostic and
prognostic biomarkers), and also highlight several exosomes with CRC
clinical trials, as well as future directions of exosome-based CRC
research. Hopefully, it will encourage several researchers to develop
a potential exosome-based theranostic tool to fight CRC.