Decoding microRNAs as potential biomarkers and therapeutic targets in head and neck cancer

Head and neck squamous cell carcinomas (HNSCCs) are a diverse and clinically aggressive group of neoplasia, with poor overall survival, high recurrence, and low response to different types of treatment. Recent findings have revealed that microRNAs (miRNAs) are potent regulators of gene expression and have the potential to modulate key tumor-suppressive and oncogenic signaling pathways that mediate proliferation, metastasis, and treatment resistance. This review highlights the dual functions of miRNAs as oncogenes and tumor suppressors with respect to their biogenesis and functional roles in HNSCC. Abnormal miRNA expression patterns in HNSCC are discussed to provide clinical implications for diagnosis, prognosis, and treatment. Specifically, the review addresses drawbacks of miRNA-based therapeutics, such as context dependency, off-target effects, and delivery considerations. The implementation of current advances in antigomiR technologies—including locked nucleic acids, modified oligonucleotides, and nanoparticles as delivery vehicles—is discussed in relation to clinical practice. Despite challenges, miRNAs remain highly relevant tools in precision oncology, with applications ranging from early detection to potentially overcoming chemo- and radioresistance. This review emphasizes the urgent need for refined therapeutic frameworks that leverage miRNA biology in HNSCC treatment. The literature for this review was retrieved from PubMed and Google Scholar, with Research Rabbit used for citation mapping.