A-to-I editing technologies: unlocking new avenues in cancer therapy

This review examines the critical role of adenosine-to-inosine (A-to-I) RNA editing in oncology, focusing on its molecular mechanisms, clinical relevance, and therapeutic applications. The ADAR family of enzymes mediates A-to-I editing, influencing RNA stability, translation efficiency, and immune modulation. Dysregulated ADAR activity has shown a relationship with multiple cancers, including glioma, hepatocellular carcinoma, and breast cancer. This review is structured into three main sections. First, we provide an overview of the mechanisms of RNA editing and its regulatory functions in cancer biology. Next, we highlight its clinical relevance, particularly how altered RNA editing contributes to oncogenesis and immune evasion. Finally, we explore therapeutic strategies, including ADAR inhibitors, antisense oligonucleotides (ASOs), and inosine-mediated RNA modifications to restore gene expression balance. Restoring ADAR function involves correcting RNA editing imbalances, particularly tumor cells' disrupted equilibrium between ADAR1 and ADAR2. This modulation can counteract oncogenic RNA changes and enhance immunotherapy efficacy. We also elaborate on the clinical applications of RNA editing in precision medicine, highlighting its potential to revolutionize cancer therapy. Unlike permanent genomic modifications, RNA editing provides a reversible and dynamic approach, making it an attractive strategy for targeted cancer interventions. Integrating RNA editing strategies into oncology and biomedical research could pave the way for new therapeutic advances.