Exosome-based cancer assays

1. A method of treating an overweight, obese or diabetic subject with cancer, the method comprising administering

(i) a glucose-controlling medication, or obesity medication and/or

(ii) CT scans at a frequency of higher than one CT scan every 6 months to an overweight, obese or diabetic subject with cancer determined to have

(a) an expression level of at least one gene selected from: miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, TSP5, SNAI1, TWIST1, SNAI2, vimentin (VIM), ZEB1 and AHNAK in an exosome originating from the adipose tissue or adipocytes of the subject, wherein the expression level of the at least one gene is increased relative to a reference; or

(b) an expression level of at least one gene selected from: miR424-5p, miR-326, miR-27a-3p, miR320b and miR320d in an exosome originating from the adipose tissue or adipocytes of the subject, wherein the expression level of the at least one gene is decreased relative to a reference.

2. The method of claim 1 , wherein the glucose-controlling medication is selected from the group consisting of: metformin, a sulfonylurea, a glinide, a SGLT2 inhibitor, and insulin; or

the obesity medication selected from the group consisting of:

orlistat, phentermine-topiramate, naltrexone-bupropion, liraglutide, semagludtide, setmelanotide, phentermine, benzphetamine, diethylpropion, and phendimetrazine.

3. The method of claim 1 , wherein the cancer is an epithelial adenocarcinoma, esophageal cancer, pancreatic cancer, cervical cancer, colorectal cancer, gastric cancer, lung cancer, uterine cancer, renal cancer, breast cancer, or prostate cancer.

4. The method of claim 1 , wherein the cancer is an epithelial cancer.

5. The method of claim 1 , wherein the overweight, obese, or diabetic subject with cancer is administered a glucose-controlling medication or obesity medication.

6. A method of treating an overweight, obese or diabetic subject with cancer, the method comprising administering at least one CT scan to an overweight, obese or diabetic subject with cancer determined to have

(a) an expression level of at least one gene selected from: miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, TSP5, SNAI1, TWIST1, SNAI2, vimentin (VIM), E-cadherin (CDH1), ZEB1 and AHNAK in an exosome originating from the adipose tissue or adipocytes of the subject, wherein the expression level of the at least one gene is not increased relative to a reference; or

(b) an expression level of at least one gene selected from: miR424-5p, miR-326, miR-27a-3p, miR320b and miR320d in an exosome originating from the adipose tissue or adipocytes of the subject, wherein the expression level of the at least one gene is not decreased relative to a reference,

wherein the at least one CT scan is administered at a frequency of no more than one CT scan every six months.

7. A method comprising:

determining the expression of at least one gene selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, miR-375, TSP5, Snail Family Transcriptional Repressor 1 (SNAI1), Twist Family bHLH Transcription Factor 1 (TWIST1), Snail Family Transcriptional Repressor 2 (SNAI2), vimentin (VIM), ZEB1, AHNAK, miR-424-5p, miR-326, miR-27a-3p, miR320b, and miR320d;

in an exosome obtained from a subject;

wherein the expression of at least four genes selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375;

is determined.

8. The method of claim 7 , wherein the expression of at least miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375; is determined.

9. The method of claim 7 , wherein one of the at least four genes is miR374a-5p.

10. The method of claim 7 , wherein the level of expression is the level of mRNA.

11. The method of claim 7 , wherein the exosome originates from or is isolated from a non-tumor tissue or cells.

12. The method of claim 11 , wherein the non-tumor tissue or cells is blood, plasma, adipose tissue, adipocytes, or bone.

13. The method of claim 7 , wherein the exosome originates from adipose tissue or adipocytes.

14. The method of claim 7 , wherein the exosome is 35-150 nm in diameter and originates from adipose tissue or adipocytes.

15. A method comprising:

determining the expression of at least one gene selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, miR-375, TSP5, Snail Family Transcriptional Repressor 1 (SNAI1), Twist Family bHLH Transcription Factor 1 (TWIST1), Snail Family Transcriptional Repressor 2 (SNAI2), vimentin (VIM), ZEB1, AHNAK, miR-424-5p, miR-326, miR-27a-3p, miR320b, and miR320d;

in an exosome obtained from a subject;

wherein the exosome originates from adipose tissue or adipocytes.

16. The method of claim 15 , wherein the expression of at least one gene selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, miR-375, miR-424-5p, miR-326, miR-27a-3p, miR320b, and miR320d;

is determined.

17. The method of claim 15 , wherein the expression of at least one gene selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375;

is determined.

18. The method of claim 15 , wherein the expression of at least two genes selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375;

is determined.

19. The method of claim 15 , wherein the expression of at least three genes selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375;

is determined.

20. The method of claim 15 , wherein the expression of at least four genes selected from the group consisting of:

miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375;

is determined.

21. The method of claim 15 , wherein the expression of at least miR374a-5p, miR-93-5p, miR-28-3p, miR-let-7b-3p, and miR-375; is determined.

22. The method of claim 15 , wherein the expression of at least miR374a-5p is determined.

23. The method of claim 15 , wherein the level of expression is the level of mRNA.

24. The method of claim 15 , wherein the exosome is 35-150 nm in diameter and originates from adipose tissue or adipocytes.