Exosomal miRNA-based theranostics in cervical cancer: bridging diagnostics and therapy

Cervical cancer (CC) remains a significant global health burden, particularly in low- and middle-income countries, where access to effective screening and treatment is limited. Despite advancements in conventional therapies, such as surgery, chemotherapy, and radiotherapy, challenges related to late-stage diagnosis, treatment resistance, and disease recurrence persist. The emergence of microRNAs (miRNAs) as key regulators of gene expression has revolutionized cancer diagnostics and therapeutics. Exosomal miRNAs, in particular, have garnered attention due to their stability, detectability in bodily fluids, and pivotal roles in tumor progression, metastasis, and immune modulation. This review provides a comprehensive overview of the role of exosomal miRNAs in the theranostic landscape of CC. We explore their involvement in disease pathogenesis, highlighting their potential as minimally invasive diagnostic biomarkers for early detection and disease monitoring. Furthermore, we examine their utility in therapeutic strategies, including miRNA-mediated drug delivery systems and miRNA-targeted interventions to overcome chemoresistance. Integrating exosomal miRNA profiling with current diagnostic modalities could enhance screening sensitivity and specificity, while miRNA-based therapies offer novel avenues to improve treatment efficacy. This review discusses recent advancements in miRNA research, current challenges in clinical translation, and future perspectives on leveraging exosomal miRNAs for personalized CC care.