MiR-1246, as the most enriched miRNA in hypoxic glioma-derived exosomes (H-GDEs), induced M2 macrophage polarization by targeting telomeric repeat sequence binding factor 2 interaction protein (TERF2IP) via the STAT3 and NF-κB pathways, and the polarized M2 macrophages subsequently promoted glioma proliferation, migration and invasion. Here, NFKB1 is linked to central nervous system cancer.