Progress and challenges in the use of Cofilin-1 as a prognostic and predictive biomarker for cancer management.

Cofilin-1 (CFL1) is an actin-regulating protein encoded by the CFL1 gene and plays a central role in cytoskeletal dynamics, cell motility, and invasion-processes critical for tumor progression and metastasis. Aberrant CFL1 expression has been linked to poor prognosis, therapeutic resistance, and increased metastatic potential across several human cancers. This review consolidates clinical evidence from studies involving human samples over the past 15 years, highlighting CFL1 as a candidate prognostic and predictive biomarker. We analyze tumor-specific expression patterns, detection methodologies as immunohistochemistry, ELISA, proteomics and discuss regulatory pathways involving CFL1. Particular attention is given to prostate cancer, where the lack of reliable molecular biomarkers for risk stratification represents a clinical gap. Despite promising associations, the clinical translation of CFL1 is hindered by heterogeneity in quantification protocols and limited prospective validation. We outline the key challenges and propose future directions to establish CFL1 as a clinically actionable biomarker, with potential relevance to personalized cancer management.