Epitranscriptomic signatures of malignancy: how RNA modifications shape breast and ovarian tumor progression

Breast and ovarian cancers are still one of the most prevalent causes of cancer death among the women in all parts of the world, mostly occurring at a later stage with high recurrence rate and resistance to treatment. Beyond the well-known genetic and epigenetic modifications, the new branch of study is epitranscriptomics that investigates reversible chemical modifications of RNA has brought a new aspect of cancer regulation to light. Modifications such as N6-methyladenosine (m6A), 5-methylcytosine (m5C), pseudouridine (Psi), and N1-methyladenosine (m1A) have dramatic effects on RNA stability, splicing, localization, and translation, which alter oncogenic signalling, immune evasion, and drug resistance. Reprogramming of the transcriptome and proteome with dysregulation of the respective corresponding writers, erasers, and readers of these RNA scripts, enhance tumor proliferation, epithelial-mesenchymal transition (EMT), angiogenesis, and metastasis. Recent developments highlight the putative clinical value of targeting RNA modifying enzymes using small-molecule inhibitor, CRISPR-based editing technology, and delivery systems based on nanotechnology. In addition, RNA modification patterns are emerging as promising diagnostic and prognostic biomarkers, with growing applications in liquid biopsy and precision oncology. A combination of epitranscriptomic data and multi-omics solutions, artificial intelligence (AI), and personalized medicine frameworks offers an effective way of optimizing cancer classification and treatment. This review highlights, how decoding of epitranscriptomic signatures of malignancy can help transform the concept of tumor biology and provide with new avenues of diagnosis, prognosis, and targeted therapy options of breast and ovarian malignancies, representing a new era of patient-centred oncology.