Targeting miRNAs in renal cell carcinoma: emerging therapeutic strategies

About one-third of renal cell carcinoma (RCC) patients present with metastatic disease upon diagnosis because of the retroperitoneal location of the kidneys, which causes many tumors to stay asymptomatic. Besides, shortly after 5 years following successful curative surgery, nearly 30% of individuals develop distant cancer metastases and recurrences. This is mostly attributable to the complex and diverse characteristics of the tumor microenvironment. Although targeted treatments and immunotherapies can extend the survival of patients, they are linked to the swift emergence of resistance, constraining the therapeutic alternatives for RCC patients and drawing attention to the critical requirement for improved targeted treatments. Along the same vein, there is an urgent demand for novel biomarkers capable of detecting early RCC with significant sensitivity and specificity. Additionally, prognostic indicators are required for the stratification of RCC patients. MicroRNAs (miRNAs) are crucial regulators of mRNA and subsequent protein production in both healthy and malignant tissues. The malignant pathophysiology of RCC has been associated with miRNA dysregulation, which impacts numerous cellular processes and has been found to increase the likelihood of proliferative and invasive processes, promote angiogenesis, alter cell cycle dynamics, evade cell death, facilitate metastasis, and make cancer cells less responsive to certain treatments. Therefore, in this review, we will go over the latest findings regarding the functions of oncogenic and tumor suppressor miRNAs in RCC, how they could be used as diagnostic and prognostic indicators for RCC, and the role they play in the development of RCC and its resistance to cancer-fighting therapies.