<em>miR-181a</em>: Regulatory Roles, Cancer-Associated Signaling Pathway Disruptions, and Therapeutic Potential

Introduction: microRNA-181a (miR-181a) is a crucial post-transcriptional regulator of many mRNA transcripts and ncRNAs, influencing cell proliferation, cancer cell stemness, apoptosis, and immune responses. Its abnormal expression has been characterized in numerous cancers, making it a significant genomic vulnerability and biomarker in cancer research. Areas Covered: Here, we summarize miR-181a&rsquo;s correlation with poor patient outcomes across numerous cancers, and the mechanisms governing miR-181a&rsquo;s activity and processing. We comprehensively describe miR-181a&rsquo;s involvement in multiple regulatory cancer signaling pathways, cellular processes, and the tumor microenvironment. We also discuss current therapeutic approaches to targeting miR-181a, highlighting their limitations and future potential. Expert Opinion: miR-181a is a clinically relevant pan-cancer biomarker with potential as a therapeutic target in cancer. Its regulatory control of tumorigenic signaling pathways and immune responses positions it as a promising candidate for more personalized treatments. The success of miR-181a as a target relies on the development of specific therapeutics platforms. Future research on miR-181a's role in the tumor microenvironment and the RNA binding proteins that regulate its stability will help uncover new techniques to targeting miR-181a. Further research into miR-181a serum levels in patients undergoing therapy will help to better stratify patients and enhance therapeutic success.