In summary, M2 macrophage-derived EVs may aggravate NSCLC under hypoxic conditions via three identified axes (NDRG1-009-miR-34c-5p-VEGFA, NDRG1-006-miR-346-EGLN3, and NDRG1-009-miR-205-5p-VEGFA). This evidence concerns the gene VEGFA and non-small cell lung carcinoma.