Hyaluronic acid (HA) is a significant
glycosaminoglycan component of the extracellular matrix, playing an essential role in cell localization and proliferation. However, high levels of HA may also correlate with multidrug resistance of
tumor cells, an increased tendency to metastasize, or
cancer progression, and thus represent a very unfavorable prognosis for
cancer patients. The purpose of this review article is to summarize the results of studies describing the relationship between HA, the main
ligand of the CD44 receptor, or other components of the HA signaling pathway. In addition, we review the course of selected female
malignancies, i.e., breast, cervical, endometrial, and
ovarian cancer, with the main focus on the mechanisms oriented to CD44. We also analyze reports on the beneficial use of HA-containing preparations in adjuvant
therapy among patients with these types of
cancer. Data from the literature suggest that HA and its family members may be critical prognostic
biomarkers of selected
malignancies among women. Nevertheless, the results of the available studies are inconclusive, and the actual clinical significance of HA expression analysis is still quite enigmatic. In our opinion, the HA-CD44 signaling pathway should be an attractive target for future research related to targeted
therapy in gynecological
cancers.