miRNAs in tumor radiation response: bystanders or participants?

• miRNAs regulate the expression of components of radiation-relevant pathways.
• miRNA expression profile changes upon irradiation in normal and cancer cells.
• Modulation of specific miRNAs influences tumor cell radiosensitivity.

There is increasing interest in defining a functional association between miRNAs and tumor radiation response, with the double aim of rationally designing miRNA-based strategies to increase patient radiosensitivity and identifying novel biomarkers of treatment response. Although it has been demonstrated that several miRNAs directly regulate the expression of components of cell pathways relevant to radiosensitivity, and miRNA expression profiles change upon irradiation, understanding the causal role exerted by individual miRNAs in determining tumor radiation response is still at an early stage. Based on available experimental and clinical evidence, we discuss here the potential of miRNAs as targets and/or tools for modulating radioresponsivity at the clinical level, as well as possible predictive biomarkers, underlining present limits and future perspectives.