The aberrant use of alcohol is a major factor in
cancer progression and
metastasis. Contributing mechanisms include the systemic effects of alcohol and the exchange of bioactive molecules between cancerous and non-cancerous cells along the brain-gut-liver axis. Such interplay leads to changes in molecular, cellular, and biological functions resulting in
cancer progression. Recent investigations have examined the role of extracellular vesicles (EVs) in
cancer mechanisms in addition to their contribution as diagnostic
biomarkers. Also, EVs are emerging as novel cell-free mediators in pathophysiological scenarios including alcohol-mediated gut microbiome
dysbiosis and the release of nanosized EVs into the circulatory system. Interestingly, EVs in
cancer patients are enriched with oncogenes,
miRNA,
lipids, and
glycoproteins whose delivery into the hepatic microenvironment may be enhanced by the detrimental effects of alcohol. Proof-of-concept studies indicate that alcohol-associated
liver disease is impacted by the effects of exosomes, including altered immune responses, reprogramming of stromal cells, and remodeling of the extracellular matrix. Moreover, the culmination of alcohol-related changes in the liver likely contributes to enhanced hepatic
metastases and poor outcomes for
cancer patients. This review summarizes the numerous aspects of exosome communications between organs with emphasis on the relationship of EVs in alcohol-associated diseases and
cancer metastasis. The potential impact of EV cargo and release along a multi-organ axis is highly relevant to the promotion of tumorigenic mechanisms and metastatic disease. It is hypothesized that EVs target recipient tissues to initiate the formation of prometastatic niches and
cancer progression. The study of alcohol-associated mechanisms in metastatic
cancers is expected to reveal a better understanding of factors involved in the growth of secondary
malignancies as well as novel approaches for therapeutic interventions.