Muhammad Tahir Hayat Science Reviews - Biology, 2024, 3(1), 1-8

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The Role of Non-Coding RNAs in Cancer Progression:

A Concise Comprehensive Review

Muhammad Tahir Hayat, PhD.

Department of Biotechnology, Faculty of Biological Sciences, Quaid-i-Azam University, 45320, Islamabad, Pakistan;

tahirhayatpk@yahoo.com

https://orcid.org/0000-0001-9304-9425

https://doi.org/10.57098/SciRevs.Biology.3.1.1

Received February 28, 2024. Revised March 17, 2024. Accepted March 18, 2024.

Abstract: Cancer is among one of the most widespread diseases globally and poses a great threat to human

wellbeing. Non-coding RNAs (ncRNAs) compose most transcripts but cannot undergo translation. Thus, no

proteins are made by them. However, studies have shown that ncRNAs can mimic both oncogenes and tumour

suppressor genes involved in cancer. This review discusses recent research on the involvement of ncRNAs in

the progression, diagnosis, and treatment of cancer. These ncRNAs consist of microRNAs, long non-coding

RNAs (lncRNAs) and circular RNAs (circRNAs). This concise paper aims to inform researchers, clinicians, and

scientists in navigating the dynamic field of ncRNAs in cancer with the goal of fostering collaboration to

translate discoveries into practical clinical advancements.

Keywords: Non-coding RNAs, cancer, ncRNAs; microRNAs; cancer progression.

Introduction

Cancer is a global disease considered a contin-

uous threat to the safety and wellbeing of human-

kind due to the large-scale challenges associated

with its diagnosis and treatment. A survey carried

out in the United States identified cancer as the sec-

ond-leading cause of human mortality after heart

disease (Siegel et al., 2019). Decades of research on

the biology of cancer has primarily concentrated on

the role of genes that code for proteins. Only re-

cently was it publicized that a family of molecules

that do not undergo translation, called non-coding

RNAs (ncRNA), also perform a consequential role

in regulating cell-based activities. Since their dis-

covery, the understanding of ncRNA has greatly

advanced, with scientists identifying a diverse and

widespread class of ncRNAs that comprise both

carcinogenic and tumor-suppressive varieties. As a

result, ncRNAs have been used as novel biomarkers

for therapeutics in hundreds of clinical studies fo-

cused on cancer. This review aims to highlight the

appreciable contribution of ncRNAs in cancer biol-

ogy by exploring their complex molecular mecha-

nisms and evaluating their potential contribution to

the accurate diagnosis and effective treatment of

cancer, while advancing current dialogue on medi-

cal advancements in the field of oncology.

Overview and classification of ncRNAs

The central dogma of molecular biology pos-

its that genetic information in the form of DNA is

transcribed into RNA and that RNA is subsequently

translated into proteins. Non-coding RNAs, or

ncRNAs, are functional RNA molecules transcribed

from DNA that are not translated into proteins

(Ding et al., 2021). High-throughput sequencing

technology has revealed that about 98% of the hu-

man genome is transcribed into ncRNAs (Birney et

al., 2007).

There are 15 different classes of ncRNAs that

are further divided into subgroups based on criteria

applied during the classification process, including

endogenous function, size, and capping (Figure 1).

The endogenous function of ncRNAs can be catego-

rized as regulatory ncRNAs and structural (also

called housekeeping) ncRNAs. Regulatory ncRNAs

operate as regulators, taking part in chromatin

Muhammad Tahir Hayat Science Reviews - Biology, 2024, 3(1), 1-8

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remodeling, transcription, post-transcriptional pro-

cesses, and signal transmission (Anastasiadou, Ja-

cob, et al., 2018). Housekeeping ncRNAs, like ribo-

somal RNAs (rRNAs) and transfer RNAs (tRNAs),

are engaged in cellular genetic processes including

protein synthesis, RNA modification, and RNA

splicing (Dozmorov et al., 2013).

On the basis of size, ncRNAs can be classified

as long ncRNAs (lncRNAs) (>200 nucleotides (nt))

and small ncRNAs (<200 nt) (Uppaluri et al., 2023).

lnccoding RNAs are characterized as untranslated

RNAs comprised of two subgroups called circRNAs

and pseudogenes (Zhang et al., 2019). There are

three short ncRNAs known to be involved in cancer.

These include piwi-interacting RNAs (piRNAs),

small interfering RNAs (siRNAs), and microRNAs

(miRNAs). Of these, microRNAs are the most prev-

alent and well-researched.

Moreover, ncRNAs exhibit diverse structural

features, and they can be classified into two types

based on capping. Capping is the first modification

made to RNA polymerase II-transcribed RNA and

takes place co-transcriptionally in the nucleus as

soon as the first 25–30 nucleotides are incorporated

into the nascent transcript (Moteki & Price, 2002;

Shatkin & Manley, 2000). Capping ncRNAs include

mRNA-like ncRNAs, characterized by a 7-methyl-

guanosine cap at the 5’ end, enhancing stability for

various cellular functions. Certain small nuclear

RNAs (snRNAs) and small nucleolar RNAs (snoR-

NAs) also undergo capping, facilitating their roles

in pre-mRNA splicing and rRNA modification, re-

spectively.

On the other hand, uncapped ncRNAs, such

as circRNAs, lack a 5’ cap and form covalently

closed loop structures, often interacting with miR-

NAs. lncRNAs may or may not have a cap, contrib-

uting to their diverse functions in gene regulation

and cellular processes. tRNAs are generally un-

capped, relying on post-transcriptional modifica-

tions for their crucial role in translation (Uppaluri et

al., 2023).

Figure 1: Classification of ncRNAs based on their type, capping, and endogenous functions

Role of ncRNAs in Cancer

Cancer is marked by cells that grow uncon-

trollably, invade other tissues (metastasize), and

lack the capacity to undergo programmed cell death

(apoptosis). Knowledge of the causes and potential

treatments of cancer has increased owing to the dis-

covery of ncRNAs and the advancement of RNA se-

quencing (RNA-seq) technology has made it

Science Reviews - Biology, 2024, 3(1), 1-8 Muhammad Tahir Hayat

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possible to investigate the transcriptome of cancer-

ous cells and tissues (Luo, 2016). RNA-seq makes it

possible to determine the frequency and sequences

of dysregulated ncRNAs in cancer (Choudhari et al.,

2020; Luo, 2016). There is substantial evidence that

dysregulated ncRNA expression and downstream

signaling pathways have a direct association with

development and progression of cancer. Figure 2 il-

lustrates the three distinct ways in which ncRNAs

influence cancer progression.

miRNAs have received the greatest research

attention when it comes to the roles played by

ncRNAs in human malignancies (Hayes et al., 2014;

Y. Wang & Lee, 2009). Recent studies have demon-

strated that secreted miRNAs not only cause RNA

interference (RNAi), but may additionally mimic

ligands that trigger prometastatic inflammatory re-

sponses in the microenvironment of the tumor

(Eichmüller et al., 2017).

There is minimal knowledge regarding the

cancer-associated functions of piRNAs. Although

more recent research has looked at the interaction

between PIWI (P-element Induced WImpy testis in

Drosophila) and piRNA in cancers, most of these in-

vestigations to date have focused on the PIWI clade

of Argonaute proteins, including regulatory roles in

stem cell and germ cell differentiation, which oper-

ate independently of piRNAs (Yu et al., 2019; Y.

Zhao et al., 2012). Numerous well-established

lncRNAs (e.g., HOTAIR, H19, MEG3, MALAT1)

have been associated with cancer. They play varied

roles in the development of cancer, particularly in

the areas of drug response, the formation of blood

vessels (angiogenesis), metastasis, cell proliferation,

and post-transcriptional gene regulation. Generally,

the impact of lncRNAs may be classified as either

tumor suppressive or tumorigenic based on the un-

derstanding gained from functional investigations.

However, many lncRNAs may exhibit both de-

pending on the context (Esquela-Kerscher & Slack,

2006; Svoronos et al., 2016).

The number of examples from research on

ncRNAs is far fewer than that of protein-coding

genes, even though genetic changes in genes pro-

ducing ncRNAs have been linked to cancer. One

well-known example is the deletion of the miR-

15/16 tumor suppressors in chronic lymphocytic

leukemia (CLL) at chromosome position 13q14.3

(Calin et al., 2002). Cancer is also related to the am-

plification of chromosomal areas expressing car-

cinogenic ncRNAs, such as FAL1 (Hung et al., 2014)

and PVT1 (Jin et al., 2019). The lncRNAs CCAT2 (B.

Chen, Dragomir, et al., 2020), H19 (Hua et al., 2016),

and ANRIL (Aguilo et al., 2016) are reportedly

linked to the risk of cancer cell proliferation due to

single nucleotide polymorphisms (SNPs).

Apart from the genetic changes inside of tran-

scribed areas, mutated promoters of ncRNAs can

also result in altered levels of gene expression. For

instance, it has been documented that promoters of

the lncRNAs NEAT1 and RMRP undergo frequent

driver mutations in breast cancer (Rheinbay et al.,

2017). In addition to mutations, cancer has also been

linked to ncRNAs producing enzymes, such as

Drosha and Dicer, which are associated with the

processing of miRNA, in addition to abnormalities

in the sequences encoding ncRNA itself

(Rupaimoole & Slack, 2017). Apart from genetic

mechanisms, epigenetic, transcriptional, or post-

transcriptional processes may also result in the up-

or down-regulation of ncRNAs linked to cancer

(Anastasiadou, Faggioni, et al., 2018; Budakoti et al.,

2021; Slack & Chinnaiyan, 2019).

Overall, a range of genetic and epigenetic fac-

tors, such as gene amplification or deletion , repres-

sion of gene transcription , aberrant biosynthesis ,

alternative splicing , and epitranscriptome modifi-

cations or “RNA editing” , including nucleotide

substitutions , methylation , and acetylation , can ac-

count for the dysregulation of ncRNAs in cancers.

Moreover, lncRNAs—particularly circRNAs—have

the ability to compete with mRNAs for miRNA

binding sites, such as endogenous RNAs (ceRNAs) .

As a result, miRNAs are unable to carry out their

regulatory functions. For instance, H19 can

"sponge" or lower the availability of let-7 to target

by mRNAs by binding to the sites for let-7 .

Muhammad Tahir Hayat Science Reviews - Biology, 2024, 3(1), 1-8

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Figure 2: Noncoding RNAs have three distinct ways for influencing caner progression: they might act as oncogenes, cancer sup-

pressors, or mediators of cancer metastasis. LncRNA H19, miR-21, and miR-17-92 primarily increase the target when utilized as

an oncogene; lncRNA PVT1, miR-372/373, and lncRNA HOTAIR, on the other hand, primarily reduce the target. Both miR-34

and lncRNA MEG3 inhibit tumors, but they also help target P53. Moreover, miR-15a and miR-16-1 impact BCL-2 and prevent

cancer, whereas lncRNA MEG3 influences autophagy and prevents cancer. Long noncoding RNA (lncRNA) affects the target and

hence affects the development of cancer when it prevents tumours from spreading.

Diagnostic and Therapeutic Implications

Research has shown that ncRNAs have utility

in serving as biomarkers for diagnosing cancer and

determining a patient’s prognosis. Biomolecules

linked to ncRNAs can be examined via a liquid bi-

opsy, which is a minimally invasive procedure that

allows for the analysis of biomolecules in the blood,

such as extracellular vesicles (EVs), circulating tu-

mor cells (CTCs), and cell-free DNA (cfDNA).

ncRNAs are stable in blood and their connection to

biomolecules found in the blood can be used an in-

dicator of cancer type and state. For example, cancer

progression and efficacy of therapy are correlated

with expression levels of miRNAs in EVs isolated

from blood samples. Moreover, lncRNAs found in

cfDNA have the ability of distinguishing varieties

of cancer (Chen, Zhang, et al., 2020; Cheng et al.,

2020; Huang et al., 2013; Zhang et al., 2017).

Tissue-based diagnostics performed on tissue

taken from surgeries or biopsies is another way that

ncRNAs are used to diagnose and characterize can-

cer because ncRNAs express themselves differently

in cancerous versus normal tissue. For example,

lncRNAs are dysregulated in several types of cancer,

like HOTAIR in breast cancer and MALAT1 in lung

cancer. Examples of dysregulated miRNAs include

the levels at which miR-21 and miR-155 are ex-

pressed in breast cancer and lymphoma, respec-

tively (Grolmusz et al., 2018; Wang et al., 2017;

Xiong et al., 2019; Zhao et al., 2018).

Beyond their potential for diagnosis, ncRNAs

also have prognostic significance in cancer. Prog-

nostic biomarkers estimate a patient's disease out-

come and the probability of disease progression.

For instance, low expression levels of miR-155 and

miR-21 are correlated with a poor prognosis for

lymphoma and breast cancer, correspondingly.

lncRNAs with a poor prognosis across a variety of

cancer types, such as HULC and HOTAIR, are per-

sistent (Chiu et al., 2018; Liu et al., 2018; Ni et al.,

2018).

Despite the potential benefits of ncRNAs for

diagnosis and treatment, ncRNAs in the context of

Science Reviews - Biology, 2024, 3(1), 1-8 Muhammad Tahir Hayat

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cancer presents challenges. Functional characteriza-

tion is impeded by intricate and poorly understood

roles and interactions within cellular pathways. Be-

cause of these intricate functions, it is still difficult

to determine the significance of specific ncRNAs in

the initiation and progression of cancer. The high

heterogeneity and contextual dependency of cancer

further complicate ncRNA studies, as their expres-

sion varies based on cancer type, stage, and patient

characteristics. Moreover, identifying and validat-

ing ncRNAs as diagnostic or prognostic biomarkers

is complex, facing challenges such as technical var-

iability and inter-patient variability. Utilizing ther-

apeutic potential encounters hurdles in delivery

and targeting, requiring efficient systems to mini-

mize off-target effects. Regulatory considerations

are crucial for development, requiring adherence to

guidelines and safety assessments. Despite these

challenges, understanding and harnessing ncRNA

potential in cancer holds promise for improved di-

agnostic and therapeutic interventions. However,

obstacles like lack of specificity and limited mecha-

nistic understanding remain significant barriers (Di

Leva & Croce, 2013; Uppaluri et al., 2023).

Conclusion and perspectives

In conclusion, the study of non-coding RNAs

in cancer progression has unveiled a range of regu-

latory mechanisms and potential therapeutic op-

tions. MicroRNAs, due to their precise gene expres-

sion regulation, play a crucial role in coordinating

cellular activities essential for tumor development.

Long non-coding RNAs add complexity to the reg-

ulatory network, influencing various aspects of can-

cer biology as functional modulators and architec-

tural planners. Targeting ncRNAs for therapeutic

purposes shows promise for innovative cancer

treatments, with opportunities for personalized and

targeted interventions through small molecules and

RNA-based therapeutics. However, challenges

such as delivery methods, off-target effects, and un-

derstanding ncRNA interactions must be addressed.

Ongoing research in ncRNAs in cancer biology re-

mains a dynamic field with vast potential. Interdis-

ciplinary collaboration will be crucial to overcome

challenges and translate discoveries from research

to clinical applications.

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