Liquid biopsy is a sampling and molecular analysis of any body fluids. With the increasing applications in cancer screening, treatment stratification, as well as residual disease and recurrence surveillance, liquid biopsy has become an exciting new paradigm in the field ofcancer management. This fairly novel tech­ nique holds promise as a less invasive, real-time and morecomprehensive alternative to traditional tissue biopsy, allowing access to the evolving molecular landscape of human malignanc]es. Apart from circu­ lating tumorcells (CTCs),c)rculating tumor DNA (ctDNA) andcirculating tumor RNA (ctRNA) that were all used as potential samples for liquid biopsy, accumulating evidence showed that exosomescould also be an alternative platform with potentially broad­ er andcomplementary applications. Exosomes are small extracellular vesicles with sizes between 30- 150 nm, released by a variety ofcells, includingcan­ cercells. Exosomescan stably exist in almost all body fluids, such as blood, urine, saliva and so forth. Due to the significant advantages of exosomes over other types of liquid biopsy materials, it hascaught tremen­ dous interest in liquid biopsy research. Like most sol­ id tumors, gastrointestinal (GI) cancer detectioncur­ rently involves a multitude of invasive approaches (e. g., endoscopy / biopsy). This review summarizes and discusses the advantages andchallenges of exosome­ based liquid biopsies in gastrointestinalcancers, spe­ cifically esophageal, gastricandcolorectalcancers, with an emphasis on applications in cancer manage­ ment.

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