The Role of Non-Coding RNAs in Chemoresistance to Cancer Therapies

Abstract

Chemoresistance remains one of the greatest challenges in modern oncology and is responsible for most cancer-related deaths. Growing evidence has identified non-coding RNAs (ncRNAs) as key regulators of resistance to anticancer therapy. These molecules influence a wide range of classical resistance mechanisms, including drug efflux, apoptosis evasion, epithelial–mesenchymal transition, enhanced DNA repair, altered drug metabolism, and autophagy. The growing understanding of ncRNA biology has created new opportunities for clinical translation. Non-coding RNAs show considerable promise as predictive biomarkers of treatment response and as therapeutic targets, several of which have already entered early-phase clinical evaluation. Nevertheless, significant challenges remain, including efficient and selective delivery, off-target effects, tumor heterogeneity, and redundancy in ncRNA regulatory networks.