Role of circular RNAs in regulating toxicity induced by cancer therapies

Owing to transformative improvements in diagnosis and treatment, survival rates for cancer patients have improved significantly across the globe. However, toxicity induced by oncotherapy remains a major concern and markedly affects disease prognosis. In recent years, research on the association between circular RNAs (circRNAs) and oncotherapy-induced toxicity has received extensive attention. CircRNAs are a class of single-stranded closed-loop molecules that play a regulatory role in the occurrence and development of tumors. An integral role of circRNAs in the development of cancer treatment-induced toxicity, as well as in pathological processes such as oxidative damage, mitochondrial damage, apoptosis, dysregulation of calcium homeostasis, and dysregulation of vascular homeostasis has been deciphered. With regards to chemotherapy, radiotherapy, and immunotherapy for cancer treatment, circRNAs play crucial functions in modulating the effects of oncotherapy-induced toxicity. The current review focuses on the mechanisms by which circRNAs function in regulating cancer treatment-induced toxicity, which leads to apoptosis, mitochondrial damage, oxidative stress, DNA damage, and fibrosis. In addition, this review summarizes the potential circRNA biomarkers, treatment strategies and future challenges, which may help translate circRNA research into clinical practice for early detection and improvement of cancer treatment-induced toxicity in the future.