The potential of microRNAs in cancer diagnostic and therapeutic strategies: a narrative review

Background microRNAs (miRNAs/miRs) are endogenous non-coding RNAs that post-transcriptionally regulate gene expression. Altered miRNA expression promotes oncogenesis by changing the expression of genes involved in key biological pathways in many human cancers. Accumulating evidence reveals that miRNAs have immense potential as diagnostic and prognostic cancer biomarkers based on their capacity to function as oncogenes or tumor suppressors. In addition, translating miRNA-directed therapies from the bench to bedside holds great promise as an innovative therapeutic strategy, contributing to advanced personalized cancer treatment.Main body This narrative review synthesizes current knowledge on (1) miRNA intracellular and extracellular dynamics enabling gene regulation; (2) technologies for miRNA quantification; (3) validation of miRNA diagnostic/prognostic panels; (4) progress and challenges in developing miRNA-directed cancer therapies, and updates on miRNA clinical trials for cancer monitoring and treatment. Key discoveries and research gaps across these areas are discussed.Conclusions Cumulative research has established a fundamental understanding of miRNA biology and its correlations with cancer diagnostics and therapy strategies, supporting clinical translational potential. However, complexities within miRNA regulatory networks and methodological inconsistencies necessitate ongoing investigations. Achieving breakthroughs in measurement standardization, biomarker validation, and the development of targeted therapeutic interventions harnessing these post-transcriptional regulators remains crucial for improving cancer diagnosis and treatment.