尽管与癌干细胞（CSC）维护、扩张和肿瘤形成相关的机制和途径已得到广泛研究，而肿瘤细胞（TC）来源的外泌体在该过程中的作用也已被充分理解，但研究CSC来源的外泌体（CSC-Exo）/外泌体非编码RNA及其对恶性肿瘤的影响的研究偏少。考虑到CSCs的这些囊泡和分子组分可能通过与其他关键肿瘤微环境（TME）组分（如MSCs / MSC-Exo和CAFs / CAF-Exo）相互作用，在癌症发生、进展和复发方面产生巨大影响，这一缺陷需要解决。特别是，了解CSC / CSC-Exo及其与与增强自我更新进程相关的增殖、迁移、分化、血管生成和转移相关的MSC / MSC-Exo或CAF / CAF-Exo之间的相互作用，化疗及放疗抵抗可能有助于癌症治疗。本综述通过总结CSC-Exo / MSC-Exo / CAF-Exo的特征和功能机制及其对癌症进展和治疗抵抗的相互影响，为此做出了贡献。版权所有©2023年Elsevier B.V.发表。

Although the mechanisms as well as pathways associated with cancer stem cell (CSC) maintenance, expansion, and tumorigenicity have been extensively studied and the role of tumor cell (TC)-derived exosomes in this process is well understood, there is a paucity of research focusing specifically on the functional mechanisms of CSC-derived exosomes (CSC-Exo)/exosomal-ncRNAs and their impact on malignancy. This shortcoming needs to be addressed, given that these vesicular and molecular components of CSCs could have a great impact on the cancer initiation, progression, and recurrence through their interaction with other key tumor microenvironment (TME) components, such as MSCs/MSC-Exo and CAFs/CAF-Exo. In particular, understanding CSCs/CSC-Exo and its crosstalk with MSCs/MSC-Exo or CAFs/CAF-Exo that are associated with the proliferation, migration, differentiation, angiogenesis, and metastasis through an enhanced process of self-renewal, chemotherapy as well as radiotherapy resistance may aid cancer treatment. This review contributes to this endeavor by summarizing the characteristic features and functional mechanisms of CSC-Exo/MSC-Exo/CAF-Exo and their mutual impact on cancer progression and therapy resistance.Copyright © 2023. Published by Elsevier B.V.