Exercise-induced modulation of circulating and exosomal microRNAs and long non-coding RNAs: Molecular signatures in...

Physical exercise has emerged as a powerful modulator of molecular pathways involved in cancer development, progression, and therapeutic response. Recent evidence highlights the pivotal role of circulating and exosomal non-coding RNAs-including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs)-as mediators linking exercise to systemic and tumor-specific adaptations. These molecules regulate key processes such as cell proliferation, apoptosis, angiogenesis, inflammation, and immune modulation, thereby influencing the tumor microenvironment and overall cancer trajectory. Exercise-induced alterations in circulating and exosomal miRNAs and lncRNAs have been shown to reflect molecular reprogramming at both systemic and cellular levels, suggesting their potential as minimally invasive biomarkers for cancer diagnosis, prognosis, prevention, and treatment monitoring. Furthermore, exosomal non-coding RNAs serve as intercellular communicators, transferring exercise-mediated molecular signals to target tissues, which may contribute to improved therapeutic efficacy and reduced tumor progression. This review synthesizes current evidence on how different exercise modalities modulate circulating and exosomal miRNAs and lncRNAs in cancer, emphasizing their diagnostic and prognostic potential and the underlying molecular mechanisms. Understanding these interactions provides novel insights into how physical activity can be harnessed as an adjuvant strategy in precision oncology, paving the way for predictive, preventive, and personalized approaches to cancer management.