Schlafen 11 as a predictive biomarker and therapeutic target in cancer: From mechanisms to clinical application

The emergence of chemotherapy resistance remains a pivotal challenge in oncology, driving the search for robust biomarkers of drug sensitivity. Schlafen 11 (SLFN11) is well established as a predictive biomarker for the response to DNA-damaging agents; however, its clinical translation is hindered by key challenges. This review systematically synthesizes current evidence on SLFN11, detailing its structure, multifaceted mechanisms, dynamic expression patterns, and epigenetic regulation. We evaluate detection methodologies, highlight the promise of dynamic monitoring via liquid biopsy, and explore rational combination therapies designed to leverage SLFN11 function. Finally, we provide a forward-looking perspective on integrating SLFN11 into biomarker-driven strategies and outline the clinical validation required to realize its full potential in precision oncology.