PAX3-FOXO1 altered exosome content of miRNA, with expected influenced networks centering on cancer and inflammation pathways, and proteins well recognized to play a role in RMS tumor biology, including IGF1 and IGF1R, CDKN1B, SMAD 2/3, SIRT1, TP53, and the epigenetic regulator SMARCA4. This evidence concerns the gene SIRT1 and neoplasm.