It has been proven that exosome-derived circCCAR1 enhances CD8 + T cell dysfunction and anti-PD1 resistance in patients diagnosed with hepatocellular carcinoma [109]; but also, cancer cell-derived exosomal circUSP7 might induce CD8+ T cell dysfunction and anti-PD1 resistance through the regulation of the miR-934/SHP2 axis in NSCLC patients [111]. This evidence concerns the gene CD8A and non-small cell lung carcinoma.