KEGG pathway analysis of genes associated with the serum exosomal circRNAs revealed significant enrichment in several oncologically relevant pathways, including “transcriptional misregulation in cancer,” “motor proteins,” “ErbB signaling pathway,” and “cell adhesion molecules.” While diverse, these pathways are not isolated but can be integrated into a coherent model of tumor aggression, with Notch signaling potentially serving as a central orchestrator. Here, IMMT is linked to neoplasm.