MicroRNAs as key regulators of cancer drug resistance: insights and future directions in chemotherapy, targeted-therapy, radiotherapy, and immunotherapy

Cancer therapy remains an active field of investigation, particularly in understanding and overcoming therapy resistance. Small non-coding RNAs, such as microRNAs (miRNAs), are emerging as key regulators of cancer survival, progression, proliferation, invasion, migration, and metastasis. Although many studies have linked miRNAs to cancer therapy outcomes, significant questions remain regarding their precise molecular and cellular roles in therapy resistance. Increasing evidence shows that miRNAs influence critical pathways such as apoptosis, immune evasion, and other signaling cascades. However, there have been many setbacks because of the limitations in knowledge of each specific miRNA's function. A deeper understanding of miRNA expression and function may enhance the development of more effective cancer therapeutics and improve overall survival of patients. This review explores the role of miRNA expression as a key regulator of therapeutic resistance in cancer patients.