Exploring non-coding RNAs in Prostate Cancer: from Biomarkers to Therapeutic Strategies

Abstract

Prostate cancer (PCa) is the second most prevalent malignancy and a leading cause of can- cer-related mortality in males worldwide. Despite advancements in therapeutic strategies, such as radical prostatectomy, radiotherapy, androgen deprivation therapy (ADT), and chemotherapy, treatment outcomes for metastatic castration-resistant PCa (mCRPC) re- main suboptimal. The androgen receptor (AR) and its downstream signaling pathways play a critical role in PCa progression. Genetic aberrations such as AR amplification, TP53 and PTEN loss, and MYC oncogene activation further drive disease advancement. Although prostate-specific antigen (PSA)-based screening is widely used, its limited impact on sur- vival underscores the need for more reliable biomarkers. Emerging evidence indicates that non-coding RNAs (ncRNAs), including long non-coding RNAs (lncRNAs), circular RNAs (circRNAs), and microRNAs (miRNAs), act as key regulators of gene expression. These molecules influence PCa cell proliferation, apoptosis, invasion, and metastasis. Their dif- ferential and stage-specific expression patterns suggest strong potential as diagnostic and prognostic biomarkers, as well as therapeutic targets. This review summarizes recent ad- vancements in ncRNA research in PCa, providing insights into their mechanistic roles, clin- ical applications, and future directions in precision oncology.