In metastatic tissues, SIRT1 expression remained elevated, whereas FoxO3a and miR-34a levels were significantly reduced (p < 0.05).<h4>Conclusion</h4>SIRT1 may act as either a tumor suppressor or a tumor promoter, depending on cellular context, signaling pathways, and its specific molecular targets across cancer types. Here, FOXO3 is linked to cancer.