Circulating microRNAs in prostate cancer — non-invasive biomarkers for diagnosis, prognosis and therapy: A review

Authors

  • Ema Volar University of Zagreb, School of Medicine, Zagreb, Croatia https://orcid.org/0009-0007-1144-217X
  • Borna Vuković University of Zagreb, School of Medicine, Zagreb, Croatia https://orcid.org/0009-0004-5375-9261
  • Ivan Franin Clinical Department of Pathology and Cytology “Ljudevit Jurak”, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
  • Zrinka Madunić Oncology and Nuclear Medicine Department, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia https://orcid.org/0009-0004-5318-9115
  • Anita Bijelić AstraZeneca, Zagreb, Croatia; Department of Biology, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia. https://orcid.org/0009-0004-0824-5210
  • Ivana Čelap Clinical Department of Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia.
  • Nino Sinčić Department of Medical Biology, School of Medicine, University of Zagreb, Zagreb, Croatia; Scientific Center of Excellence for Reproductive and Regenerative Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia.
  • Igor Tomašković Clinical Department of Urology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
  • Jure Murgić Oncology and Nuclear Medicine Department, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
  • Monika Ulamec Clinical Department of Pathology and Cytology “Ljudevit Jurak”, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia; Scientific Center of Excellence for Reproductive and Regenerative Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia; Pathology Department, School of Medicine University of Zagreb, Zagreb, Croatia.

DOI:

https://doi.org/10.17305/bb.2025.12971

Keywords:

Prostate cancer, miRNA, biomarkers, diagnosis, therapy, tumor microenvironment

Abstract

Prostate cancer (PC) is a common malignancy driven by interacting genetic, environmental, and lifestyle factors, including hereditary mutations (BRCA1/2, HPC1, AR variants), premalignant lesions [proliferative inflammatory atrophy (PIA), prostatic intraepithelial neoplasia (PIN)], and Western dietary patterns. This narrative review aims to synthesize evidence on the role of microRNAs (miRNAs) in PC pathogenesis and clinical management across diagnosis, prognosis, therapy, and recurrence prediction. We searched PubMed/MEDLINE (2004–present) using predefined terms, screened reference lists, excluded outdated records, and prioritized biomarker studies with AUC ≥ 0.85. Current diagnostic pathways—digital rectal examination, prostate-specific antigen (PSA) testing, multiparametric MRI, and Gleason-based International Society of Urological Pathology (ISUP) grading—are complemented by molecular tools (4Kscore, PHI, SelectMDx, TMPRSS2–ERG, PCA3, ConfirmMDx). MiRNAs, key post-transcriptional regulators, contribute to PC via dysregulated biogenesis and modulation of androgen receptor signaling within an inflamed, remodeled tumor microenvironment. Circulating and exosomal miRNAs (notably miR-21, miR-375, and miR-182-5p) exhibit greater specificity and stability than PSA, enabling non-invasive diagnosis, risk stratification, treatment monitoring, and recurrence prediction. Therapeutic approaches—antagomirs, sponges, miRNA masks, and CRISPR editing—show preclinical promise, while chemical modifications [peptide nucleic acids (PNAs), locked nucleic acids (LNAs), C2′ modifications] improve stability and delivery but remain limited by biodistribution, tissue penetration, off-target effects, and immunogenicity. In conclusion, standardized workflows and multicenter validation, integrated with clinical and imaging data, are essential to translate miRNA-based tools into precision PC management.

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Circulating microRNAs in prostate cancer — non-invasive biomarkers for diagnosis, prognosis and therapy: A review

Published

06-10-2025

How to Cite

1.
Circulating microRNAs in prostate cancer — non-invasive biomarkers for diagnosis, prognosis and therapy: A review. Biomol Biomed [Internet]. 2025 Oct. 6 [cited 2025 Oct. 8];. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/12971