Non-Coding RNAs and cernas: emerging modulators of drug response in colorectal cancer

Colorectal cancer (CRC) is still one of the most common cancers and a leading cause of cancer morbidity worldwide. A significant issue that should be paid much attention to is its resistance to anticancer agents. Non-coding RNAs (ncRNAs), such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), have been identified as important regulators of drug response and drug resistance in CRC. In this review, we provide a comprehensive assessment of the studies conducted in the field of investigating the role of ncRNAs in drug resistance to prominent anticancer agents used in CRC, including 5-fluorouracil (5-FU), oxaliplatin, cetuximab, bevacizumab, and regorafenib. We focussed specifically on the miRNAs, lncRNAs, and circRNAs associated with resistance to each drug individually, even within the context of combination therapies, such as FOLFOX. We also reviewed competing endogenous RNA (ceRNAs) networks and their relationship with drug sensitivity and resistance and new therapeutic strategies to manage drug resistance in CRC and also analyzed the role of ceRNA networks in modulating drug response and its implications for new approaches to overcome drug resistance in CRC. This article also discusses findings from human clinical trials, highlighting evidence from patient studies that validate the role of targeting ceRNA and ncRNA networks in improving drug sensitivity, overcoming resistance, and enhancing therapeutic outcomes in CRC. It supports the targeting of ncRNA and ceRNA networks as potential therapies to improve treatment outcomes and drug resistance in CRC.