Emerging role of circular RNAs in gastric cancer: From basic biology to clinical applications (Review).

Despite considerable advances in cancer treatment, gastric cancer (GC) remains a formidable challenge for oncologists worldwide, especially due to the poor survival rates associated with advanced‑stage cases. Circular RNAs (circRNAs) stand out as potential targets for more effective therapeutic strategies. The present review synthesizes insights into the roles of circRNAs in GC, highlighting their multifaceted influence on cancer progression and behaviors. circRNAs can regulate gene expression at multiple levels through modulating transcription, affecting alternative splicing, acting as molecular sponges for microRNAs, serving as RNA‑protein complexes and even encoding functional proteins. The marked stability of circRNAs in bodily fluids has also positioned them as promising diagnostic biomarkers, with some circRNA‑based tests demonstrating high accuracy. Furthermore, emerging evidence indicates that circRNAs carry out a key role in therapy resistance, affecting the therapeutic responses of patients to chemotherapy, targeted therapy and immunotherapy. Collectively, circRNA‑based therapeutic strategies, even with existing challenges in delivery methods, hold considerable promise, particularly when integrated with conventional treatment modalities, offering new avenues for improving GC management.