RNA methylation in urological cancers: regulatory logic, biological functions, and clinical relevance

Urological malignancies, including prostate, bladder, and renal cancers, remain a major clinical challenge because of tumor heterogeneity, disease progression, and therapeutic resistance. In this context, RNA methylation has emerged as an important post-transcriptional regulatory layer in cancer biology.

Importantly, the biological consequences of RNA methylation are not dictated by chemical modifications alone, but by coordinated networks of regulatory proteins that install, remove, and interpret these marks, thereby shaping RNA fate and gene expression programs. Among currently studied RNA modifications, N6-methyladenosine (m6A) provides the most mature mechanistic framework, whereas non-m6A regulators remain comparatively less well characterized.

In this review, we systematically summarize the regulatory logic underlying RNA methylation-mediated control in urological cancers, with particular emphasis on how distinct classes of regulatory proteins influence RNA stability, translation, metabolism, and other post-transcriptional processes. We further integrate current evidence across multiple RNA methylation types, including m6A, 5-methylcytosine (m5C), N1-methyladenosine (m1A), and N7-methylguanosine (m7G), while highlighting the relative immaturity of non-m6A evidence in these malignancies.

We also provide an overview of current m6A detection technologies and discuss their methodological strengths, limitations, and appropriate research applications.