Key mechanisms include: tumor-derived exosomes carrying miRNA-155 upregulate superoxide dismutase 2/catalase (SOD2/CAT), reducing ROS to bolster survival and drug resistance [95]; ascites-derived exosomal miRNA-6780b-5p drives EMT and metastatic spread [96]; exosomes containing prokineticin receptor 1 (PKR1) or miRNA-130a fuel angiogenesis and drug resistance [97,98]; CSC-derived exosomes carrying miRNA-210 activate mechanistic target of rapamycin (mTOR), promoting drug resistance [99]. This evidence concerns the gene PROKR1 and neoplasm.