The Janus Face of PROX1 in Cancer——Context-Dependent Functionsand Therapeutic Implications

Introduction: PROX1 is a conserved transcription factor with context-dependent roles in cancer. This review evaluates its dual nature as both an oncogenic driver and a tumor suppressor. Methods: This review, which involved scanning of pertinent literature, describes and evaluates recent research on the biological functions and mechanisms of PROX1 in malignancies Results: The functions of PROX1 in cancer are highly context-dependent. In gastric cancer, colorectal cancer, and glioma, PROX1 acts as an oncogenic driver. Conversely, in pancreatic ductal adenocarcinoma, it serves as a tumor suppressor. In hepatocellular carcinoma, breast cancer, thyroid carcinoma, and vascular tumors, PROX1 exhibits a dual role. Specifically, in different types of vascular tumors, the expression of PROX1 is more closely associated with the lymphatic endothelial phenotype. Although it also partially indicates a malignant phenotype, this association is not entirely consistent. Discussion: The functional switch of PROX1 is primarily governed by its subcellular localization and interaction with specific targets. Its significant heterogeneity across cancer stages necessitates the development of more precise, context-aware diagnostic and treatment protocols Conclusion: PROX1 is a multifaceted transcription factor, with both tumor-suppressive and oncogenic roles in diverse cancers. Its diverse functions underscore the necessity for a nuanced understanding of its mechanisms in different cancer types and suggest that PROX1 holds significant potential as a therapeutic target and prognostic biomarker. This provides new avenues for the prevention and treatment of tumor diseases in the future.