结直肠癌中的 DNA 损伤反应途径和细胞周期检查点:靶向治疗的当前概念和未来展望。

DNA damage response pathways and cell cycle checkpoints in colorectal cancer: current concepts and future perspectives for targeted treatment.

机构信息

Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda (MD), USA.

出版信息

Curr Cancer Drug Targets. 2012 May;12(4):356-71. doi: 10.2174/156800912800190901.

Abstract

Although several drugs have been designed in the last few years to target specific key pathways and functions in colorectal cancer (CRC), the backbone of CRC treatment is still made up of compounds which rely on DNA damage to accomplish their role. DNA damage response (DDR) and checkpoint pathways are intertwined signaling networks that arrest cell cycle, recognize and repair genetic mistakes which arise during DNA replication and transcription, as well as through the exposure to chemical and physical agents that interact with nucleic acids. The good but highly variable activity of DNA damaging agents in the treatment of CRC suggests that intrinsic alterations in DDR pathways and cell cycle checkpoints may contribute differentially to the way cancer cells react to DNA damage. In the present review, our aim is to depict the recent advances in understanding the molecular basis of the activity of DNA damaging agents used for the treatment of CRC. We focus on the known and potential drug targets that are part of these complex and intertwined pathways. We describe the potential role of the checkpoints in CRC, and how their pharmacological manipulation could lead to chemopotentiation or synergism with currently used drugs. Novel therapeutic agents playing a role in DDR and checkpoint inhibition are assessed. We discuss the possible rationale for combining PARP inhibition with DNA damaging agents, and we address the link between DDR and EGFR pathways in CRC.

摘要

虽然在过去的几年中已经设计了几种药物来针对结直肠癌 (CRC) 中的特定关键途径和功能,但 CRC 治疗的基础仍然是由依赖于 DNA 损伤来发挥作用的化合物组成。DNA 损伤反应 (DDR) 和检查点途径是相互交织的信号网络,可阻止细胞周期,识别和修复 DNA 复制和转录过程中以及通过暴露于与核酸相互作用的化学和物理试剂中出现的遗传错误。在 CRC 治疗中,DNA 损伤剂的良好但高度可变的活性表明,DDR 途径和细胞周期检查点的固有改变可能会对癌细胞对 DNA 损伤的反应方式产生不同的影响。在本综述中,我们旨在描述理解用于治疗 CRC 的 DNA 损伤剂的作用的分子基础的最新进展。我们专注于这些复杂和相互交织的途径中的已知和潜在药物靶点。我们描述了检查点在 CRC 中的潜在作用,以及它们的药理调控如何导致与目前使用的药物产生化学增强或协同作用。评估在 DDR 和检查点抑制中发挥作用的新型治疗剂。我们讨论了将 PARP 抑制与 DNA 损伤剂联合使用的可能原理,并探讨了 DDR 和 EGFR 途径在 CRC 中的联系。

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