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磷脂酰肌醇 3-激酶信号通路的治疗靶向:结直肠癌治疗的新型靶向治疗和进展。

Therapeutic targeting of the phosphatidylinositol 3-kinase signaling pathway: novel targeted therapies and advances in the treatment of colorectal cancer.

机构信息

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

出版信息

Therap Adv Gastroenterol. 2012 Sep;5(5):319-37. doi: 10.1177/1756283X12448456.

Abstract

Colorectal cancer (CRC) is one of the leading causes of cancer-related death in the USA, and more effective treatment of CRC is therefore needed. Advances in our understanding of the molecular pathogenesis of this malignancy have led to the development of novel molecule-targeted therapies. Among the most recent classes of targeted therapies being developed are inhibitors targeting the phosphatidylinositol 3-kinase (PI3K) signaling pathway. As one of the most frequently deregulated pathways in several human cancers, including CRC, aberrant PI3K signaling plays an important role in the growth, survival, motility and metabolism of cancer cells. Targeting this pathway therefore has considerable potential to lead to novel and more effective treatments for CRC. Preclinical and early clinical studies have revealed the potential efficacy of drugs that target PI3K signaling for the treatment of CRC. However, a major challenge that remains is to study these agents in phase III clinical trials to see whether these early successes translate into better patient outcomes. In this review we focus on providing an up-to-date assessment of our current understanding of PI3K signaling biology and its deregulation in the molecular pathogenesis of CRC. Advances in available agents and challenges in targeting the PI3K signaling pathway in CRC treatment will be discussed and placed in the context of the currently available therapies for CRC.

摘要

结直肠癌(CRC)是美国癌症相关死亡的主要原因之一,因此需要更有效的 CRC 治疗方法。我们对这种恶性肿瘤分子发病机制的理解的进步导致了新型分子靶向治疗的发展。正在开发的最新靶向治疗类别之一是针对磷脂酰肌醇 3-激酶(PI3K)信号通路的抑制剂。作为包括 CRC 在内的多种人类癌症中最常失调的途径之一,异常的 PI3K 信号在癌细胞的生长、存活、迁移和代谢中起着重要作用。因此,靶向该途径具有很大的潜力为 CRC 带来新的、更有效的治疗方法。临床前和早期临床研究表明,针对 PI3K 信号的药物在治疗 CRC 方面具有潜在疗效。然而,仍然存在一个主要挑战,就是要在 III 期临床试验中研究这些药物,以观察这些早期成功是否转化为更好的患者结局。在这篇综述中,我们重点评估了我们目前对 PI3K 信号生物学及其在 CRC 分子发病机制中的失调的理解。将讨论现有药物的进展以及在 CRC 治疗中靶向 PI3K 信号通路的挑战,并将其置于 CRC 目前可用的治疗方法的背景下。

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