Functions and mechanisms of ncRNAs in breast cancer immunotherapy and targeted therapy

Breast cancer continues to be the second leading cause of cancer-related deaths among women worldwide. The heterogeneity of this disease poses a major challenge to clinical treatment. Recent advancements in molecular biology and immunology have enabled the development of highly targeted therapies for various breast cancer subtypes. A variety of immunotherapies, including immune-checkpoint blockade, cancer vaccination, and tumor microenvironment regulation, have been extensively investigated in breast cancer. The central aim of targeted therapy is to inhibit specific molecules which drive the progression of breast cancer. Despite the great progress in current clinical diagnosis and treatment, innate and acquired drug resistance still significantly limit the duration of efficacy of targeted and immunotherapy. As a class of regulatory transcripts with diverse functions, non-coding RNAs(ncRNAs) are involved in the regulation of multiple oncogenic signal axes and pathological processes. A large number of studies have confirmed that ncRNAs can mediate breast cancer drug resistance through multiple mechanisms such as regulating core signaling pathways, tumor cell proliferation and apoptosis, epigenetic modification, tumor microenvironment homeostasis, and drug metabolism. This review systematically summarizes the multiple regulatory effects of ncRNAs in breast cancer targeted therapy and immunotherapy resistance, and analyzes the research status, existing shortcomings and clinical transformation potential of ncRNA-related therapeutic methods, in order to provide a new research perspective for solving the clinical drug resistance problem and promote the development of ncRNA-targeted combined intervention strategies for breast cancer.