m5C RNA methylation in cancer: from biological mechanism to clinical perspectives.

Cancer remains a significant global health threat, characterized by high morbidity and mortality rates. Despite advancements, numerous challenges persist in cancer treatment, underscoring the urgent need for novel therapeutic strategies. As a burgeoning area of cancer research, increasing evidence highlights the critical role of 5-methylcytosine (m5C) methylation in tumorigenesis, progression, and clinical application. In this review, we systematically review the biological mechanism and clinical translational potential of m5C RNA methylation in cancer and analyze in detail the dynamic interactions between m5C regulatory proteins (writer proteins, eraser proteins, and reader proteins). We focus on the role of m5C regulatory proteins in regulating oncogenic signaling pathways, metabolic reprogramming, and immune microenvironment remodeling in different tumor types, while also exploring its clinical potential as a diagnostic marker, prognostic indicator, and target for therapy. This review not only offers a comprehensive analysis of the molecular mechanisms and tumor regulatory networks associated with m5C modification but also focuses on the clinical translational potential of m5C methylation in cancer, aiming to provide novel insights into precision cancer diagnosis and treatment.