There was a marked rise in the levels of exosome-derived miR-3913-5p and miR-184 after the initiation of osimertinib resistance.miR-3913-5p and miR-184 demonstrated greater utility in predicting resistance to osimertinib in patients with EGFR exon 21 L858R point mutations than exon 19 deletion.miR-3913-5p correlated with other tumor parameters, including platelet count, Tumor, Node, Metastasis (TNM) stage, carcinoembryonic antigen tumor marker, and the presence of distant metastases. This evidence concerns the gene CEACAM5 and neoplasm.