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Is silencing ribonucleic acid a ray of hope in esophageal cancer treatment?

Cancer of the esophagus, commonly known as esophageal cancer (EC), is first manifested as uncontrolled cell growth in the esophageal lining. It develops through the outer layers of the esophageal wall after beginning in the innermost layer. Adenocarcinoma and squamous cell carcinoma are the two types of esophageal cancer that are commonly seen. In some cases, other cancers like lymphomas, melanomas, and sarcomas can potentially develop in EC.


In this blog, we will delve into the potential of silencing RNA technology in treating esophageal cancer.


Existing therapies for EC

  • Esophageal cancer is a deadly, aggressive cancer. The ideal treatment of esophageal cancer is still a distant objective.

  • In patients with locally advanced esophageal cancer, esophagectomy is still the treatment of choice. Yet, it has negative effects like recurrence and distant metastases.

  • To overcome these issues, neoadjuvant therapy can be used, which primarily consists of chemotherapy, chemoradiotherapy, and monoclonal antibodies (mAbs) (recently added).

  • According to the current literature, chemoradiotherapy combined with esophagectomy produced superior outcomes than esophagectomy alone.

  • But some countries advocated that the usage of chemotherapy as a conventional treatment prior to surgery is beneficial in some EC cases.

  • There is still an ongoing debate about which treatment is the best. Several newer advancements like immunotherapy, laser ablation, targeted therapy, and laser-assisted endoscopy are also employed in esophageal cancer in recent times [1].


What is silencing ribonucleic acid (S-RNA)?


Esophageal cancer

It is merely a scientific term. It is also called as RNA interference. It refers to a series of events by which gene expression is negatively regulated by specific RNAs called microRNAS (they are small, single-stranded non-coding RNA molecules consisting of around 21-23 nucleotides). It has multiple applications in the field of biotechnology, nano engineering, agriculture, and medical fields. The advantages of this technology are the efficacy and specificity of RNA molecules in targeting other genes [2].


What is the role of S -RNA in EC?

  • Applying silencing RNA molecular technology is a promising approach in esophageal cancer.

  • Oncogenes which are the key factors in the pathogenesis of EC are regulated by these silencing RNA molecules.

  • As a result the expression of these oncogenes is reduced. This leads to reduced cell proliferation, migration, and invasion of tumor cells.

  • This also leads to reduced tumor metastases (spread to distant organs) and angiogenesis (formation of new blood vessels) [3].

  • With the above said mechanisms, this technology has the potential in reducing the spread of tumors in esophageal cancer [4].


Future of S-RNA in EC!


Slicing m-RNA molecules to target oncogenes is being developed for the treatment of esophageal cancer. Nonetheless, due to their complexity, care should be taken before using these novel strategies. The majority of these treatment strategies, concentrate on active targeting, which leads to side effects such as increased immunogenicity, toxicity and production costs, as well as issues with manufacturing processes. A multidisciplinary team with specialists in pharmacokinetics, genetics and oncology should work closely together in the future to produce drugs with this silencing technology with the least side effects and increased efficacy.


References


1. J. Li and S. Ma, “History and current situation of neoadjuvant treatment for locally advanced esophageal cancer,” Thorac Cancer, vol. 12, no. 17, pp. 2293–2299, Sep. 2021, doi: 10.1111/1759-7714.14069.

2. RNA Interference (RNAi).” https://www.ncbi.nlm.nih.gov/probe/docs/techrnai/ (accessed Feb. 28, 2023).

3. M. Mikhael, B. Pasha, H. Chela, V. Tahan, and E. Daglilar, “Immunological and Metabolic Alterations in Esophageal Cancer, Endocr Metab Immune Disord Drug Targets, vol. 22, no. 6, pp. 579–589, 2022, doi: 10.2174/1871530322666220127113752.

4. B.-C. Wu et al., “Potential Role of Silencing Ribonucleic Acid for Esophageal Cancer Treatment,”J Surg Res, vol. 278, pp. 433–444, Oct. 2022, doi: 10.1016/j.jss.2022.04.029.

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