“…The main reasons of chemotherapy failure are drug resistance development in tumor cells and the high susceptibility of normal tissues to treatment-related toxicity [ 6 , 7 , 8 , 9 , 10 ]. Some important multidrug resistance mechanisms in cancer are apoptosis inhibition, DNA repair, drug efflux, and altered drug metabolism [ 5 , 11 , 12 , 13 , 14 , 15 ]. Vesicle trafficking, including the release of extracellular micro-vesicles, is critical in carcinogenesis and progression, which involves invasion, metastasis, cell cycle regulation, angiogenesis, tumor immune privilege, and chromosomal aberrations, all of which contribute to the development of multidrug resistance (MDR) [ 16 ].…”