The microRNA(miRNA)-34a is a key regulator of tumor suppression. It controls the
expression of a plethora of target proteins involved in cell cycle, differentiation
and apoptosis, and antagonizes processes that are necessary for basic cancer cell
viability as well as cancer stemness, metastasis, and chemoresistance. In this
review, we focus on the molecular mechanisms of miR-34a-mediated tumor suppression,
giving emphasis on the main miR-34a targets, as well as on the principal regulators
involved in the modulation of this miRNA. Moreover, we shed light on the miR-34a role
in modulating responsiveness to chemotherapy and on the phytonutrients-mediated
regulation of miR-34a expression and activity in cancer cells. Given the broad
anti-oncogenic activity of miR-34a, we also discuss the substantial benefits of a new
therapeutic concept based on nanotechnology delivery of miRNA mimics. In fact, the
replacement of oncosuppressor miRNAs provides an effective strategy against tumor
heterogeneity and the selective RNA-based delivery systems seems to be an excellent
platform for a safe and effective targeting of the tumor.
Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with multiple genetic aberrations. Several molecular pathways involved in the regulation of proliferation and cell death are implicated in the hepatocarcinogenesis. The major etiological factors for HCC are both hepatitis B virus (HBV) and hepatitis C virus infection (HCV).Continuous oxidative stress, which results from the generation of reactive oxygen species (ROS) by environmental factors or cellular mitochondrial dysfunction, has recently been associated with hepatocarcinogenesis. On the other hand, a distinctive pathological hallmark of HCC is a dramatic down-regulation of oxido-reductive enzymes that constitute the most important free radical scavenger systems represented by catalase, superoxide dismutase and glutathione peroxidase.The multikinase inhibitor sorafenib represents the most promising target agent that has undergone extensive investigation up to phase III clinical trials in patients with advanced HCC. The combination with other target-based agents could potentiate the clinical benefits obtained by sorafenib alone. In fact, a phase II multicenter study has demonstrated that the combination between sorafenib and octreotide LAR (So.LAR protocol) was active and well tolerated in advanced HCC patients.The detection of molecular factors predictive of response to anti-cancer agents such as sorafenib and the identification of mechanisms of resistance to anti-cancer agents may probably represent the direction to improve the treatment of HCC.
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