Regulatory mechanisms and emerging diagnostic and therapeutic opportunities of non-coding RNAs in tumorigenesis: a pan-cancer perspective

Non-coding RNAs (ncRNAs) are a class of functional transcripts that are not translated into proteins and primarily include microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs). In recent years, as therapeutic challenges such as tumor heterogeneity and drug resistance have become increasingly prominent, ncRNAs have emerged as pivotal targets in cancer mechanistic research and precision intervention strategies due to their central roles in tumor initiation, progression, metastasis, and therapeutic resistance. Given the limitations of conventional treatments, inadequate early detection methods, and significant inter-individual variability, elucidating the regulatory functions of ncRNA networks have become an urgent imperative for advancing cancer diagnosis and treatment. This review systematically integrates the regulatory mechanisms of miRNAs, lncRNAs, and circRNAs in key oncogenic processes from a pan-cancer perspective, including cell proliferation, cell cycle control, apoptosis evasion, metastatic activation, and resistance reprogramming, while highlighting their hub-like roles in multi-pathway crosstalk,the application of ncRNA in cancer diagnosis and its role in treatment and prognosis. Furthermore, future research must strive for breakthroughs in areas such as the optimization of nanodelivery systems, AI-driven target identification, and dynamic multi-omics integration, with the ultimate goal of achieving the systematic translation of ncRNAs into actionable strategies for personalized precision medicine-transforming "functional transcriptional regulation" into "targetable therapeutic intervention."