The role of circular RNAs in gastric Cancer: Focusing on autophagy, EMT, and their crosstalk

Globally, gastric cancer (GC) is one of the leading causes of cancer-related mortality. GC is a major threat and concern in human societies because of the high degree of metastasis and the lack of primary diagnostic biomarkers. EMT (epithelial‒mesenchymal transmission) and autophagy through different signaling pathways can regulate GC metastasis. There is evidence that there is an association and crosstalk between EMT and autophagy. EMT-related signaling pathways affect the autophagy process. Conversely, depending on the tissue and stage of the tumor, autophagy has a dual role and can induce/inhibit EMT by modulating different signaling networks. Recent research has shown that circular RNAs (circRNAs) can affect autophagy, EMT, and crosstalk by modulating multiple signaling molecules. Thus, elucidating the interplay between EMT and autophagy and the association of circRNAs with these processes could provide new goals for the identification of biomarkers and the treatment of GC. This review comprehensively discusses the impact of EMT and autophagy on the onset and progression of GC, the functional role of circRNAs as inhibitors/activators, their regulatory mechanisms in regulating autophagy and EMT, and their potential applications as diagnostic biomarkers or anti-GC treatments. Thus, repressing EMT with circRNA-based autophagy inhibitor/activator drugs may be a new strategy that provides insights into the treatment of GC.