Although the negative prognostic role of high EpCAM baseline levels can partly be explained by greater tumour burden and corresponding worse performance status at diagnosis of the patients that were enrolled, it remains to be explained why, particularly in those patients who experienced partial response or disease stabilisation (and thus who benefited the most from palliative chemotherapy and that would have had less tumour burden after treatment), the INCREASE in exosomal EpCAM is associated with better survival outcomes. This evidence concerns the gene EPCAM and neoplasm.