Tumour derived exosomes can also contribute to the establishment of a pre-metastatic niche as a result of the exosomes being taken up by endothelial cells, inducing the expression of VEGF, VEGF-R1 and ICAM-1 resulting in enhanced angiogenesis and increased adhesion between the cancer and endothelial cells54. The gene discussed is ICAM1; the disease is neoplasm.