Recent data suggest that tumor cells remotely activate pre-metastatic niche (PMN) sites via the transfer of mRNAs and miRNAs contained within exosomes that are shed into the blood stream [8–10], as well as by TME altering factors, such as IL-4, IL-6, CSF-1 and VEGF, secreted by tumors [11]. This evidence concerns the gene VEGFA and neoplasm.