Departments of Pharmacology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, United States.
Biochem Pharmacol. 2010 Sep 1;80(5):624-37. doi: 10.1016/j.bcp.2010.04.029. Epub 2010 May 9.
The Mitogen Activated Protein Kinase (MAPK) pathway plays a key role in melanoma development making it an important therapeutic target. In normal cells, the tightly regulated pathway relays extracellular signals from cell membrane to nucleus via a cascade of phosphorylation events. In melanomas, dysregulation of the MAPK pathway occurs frequently due to activating mutations in the B-RAF and RAS genes or other genetic or epigenetic modifications, leading to increased signaling activity promoting cell proliferation, invasion, metastasis, migration, survival and angiogenesis. However, identification of ideal pathway member to therapeutically target for maximal clinical benefit to melanoma patients remains a challenge. This review provides an overview of the obstacles faced targeting the MAPK pathway and why certain therapeutic approaches succeed while others fail. The review summarizes the roles played by the proteins, therapeutic potential and the drugs available to target each member of the pathway as well as concerns related to each. Potential for targeting multiple points and inhibiting other pathways along with MAPK inhibition for optimal efficacy are discussed along with explanations for development of drug resistance, which includes discussions related to cross-talk between pathways, RAF kinase isoform switching and phosphatase deregulation. Finally, the use of nanotechnology is reviewed as an approach to target the MAPK pathway using both genetic and pharmacological agents simultaneously targeting multiple points in the pathway or in combination with other cascades.
丝裂原活化蛋白激酶(MAPK)途径在黑色素瘤的发展中起着关键作用,使其成为一个重要的治疗靶点。在正常细胞中,该途径通过一系列磷酸化事件将细胞膜的细胞外信号传递到细胞核,受到严格调控。在黑色素瘤中,由于 B-RAF 和 RAS 基因的激活突变或其他遗传或表观遗传修饰,MAPK 途径的失调经常发生,导致信号活性增加,促进细胞增殖、侵袭、转移、迁移、存活和血管生成。然而,确定理想的途径成员作为治疗靶点,以最大程度地为黑色素瘤患者带来临床获益,仍然是一个挑战。这篇综述概述了靶向 MAPK 途径所面临的障碍,以及为什么某些治疗方法成功而其他方法失败。综述总结了该途径中每个成员所扮演的角色、治疗潜力以及可用于靶向该途径的药物,以及与每个成员相关的担忧。同时还讨论了靶向多个点和抑制 MAPK 抑制作用以外的其他途径以获得最佳疗效的潜力,包括与途径之间的串扰、RAF 激酶同工型转换和磷酸酶失活相关的讨论。最后,综述了纳米技术的应用,该技术可同时使用遗传和药理学制剂,针对途径中的多个点或与其他级联结合,靶向 MAPK 途径。