CD63-mediated cloaking of VEGF in small extracellular vesicles contributes to anti-VEGF therapy resistance

Shaolin Ma, Lingegowda S. Mangala, Wen Hu, Emine Bayaktar, Akira Yokoi, Wei Hu, Sunila Pradeep, Sanghoon Lee, Paul D. Piehowski, Alejandro Villar-Prados, Sherry Y. Wu, Michael H. McGuire, Olivia D. Lara, Cristian Rodriguez-Aguayo, Christopher J. LaFargue, Nicholas B. Jennings, Karin D. Rodland, Tao Liu, Vikas Kundra, Prahlad T. RamSundaram Ramakrishnan, Gabriel Lopez-Berestein, Robert L. Coleman, Anil K. Sood

Research output: Contribution to journalArticlepeer-review


Despite wide use of anti-vascular endothelial growth factor (VEGF) therapy for many solid cancers, most individuals become resistant to this therapy, leading to disease progression. Therefore, new biomarkers and strategies for blocking adaptive resistance of cancer to anti-VEGF therapy are needed. As described here, we demonstrate that cancer-derived small extracellular vesicles package increasing quantities of VEGF and other factors in response to anti-VEGF therapy. The packaging process of VEGF into small extracellular vesicles (EVs) is mediated by the tetraspanin CD63. Furthermore, small EV-VEGF (eVEGF) is not accessible to anti-VEGF antibodies and can trigger intracrine VEGF signaling in endothelial cells. eVEGF promotes angiogenesis and enhances tumor growth despite bevacizumab treatment. These data demonstrate a mechanism where VEGF is partitioned into small EVs and promotes tumor angiogenesis and progression. These findings have clinical implications for biomarkers and therapeutic strategies for ovarian cancer.

Original languageEnglish (US)
Article number109549
JournalCell Reports
Issue number7
StatePublished - Aug 17 2021


  • CD63
  • VEGF
  • angiogenesis
  • bevacizumab
  • drug resistance
  • extracellular vesicles

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


Dive into the research topics of 'CD63-mediated cloaking of VEGF in small extracellular vesicles contributes to anti-VEGF therapy resistance'. Together they form a unique fingerprint.

Cite this