MAPK9 and cancer: The exosomal transforming growth factor beta (TGF-β) derived from HNSCCs cells can promote angiogenesis by both interacting with epithelial cells and modulating TAMs chemotaxis for pro-angiogenic functions.52 OSCC-derived exosomal thrombospondin 1 (THBS-1) activates an M1-like macrophage through p38, Akt, and SAPK/JNK signaling, which promotes cancer progression.53 M1-like TAMs enhance the OSCC epithelial–mesenchymal transition (EMT) and cancer stem cell formation through the IL-6/Jak/signal transducer and the activator of transcription 3 (Stat3)/THBS-1 axis.54