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hedgehog 信号通路与其他信号通路的相互作用是癌症联合治疗的基础。

Crosstalk between hedgehog and other signaling pathways as a basis for combination therapies in cancer.

机构信息

Articulate Science, 300 American Metro Boulevard, Suite 132, Hamilton, NJ 08619, USA.

Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.

出版信息

Cancer Treat Rev. 2014 Jul;40(6):750-9. doi: 10.1016/j.ctrv.2014.02.003. Epub 2014 Feb 24.

Abstract

The hedgehog (Hh) pathway is aberrantly activated in a number of tumors. In medulloblastoma, basal cell carcinoma, and rhabdomyosarcoma, mutations in Hh pathway genes lead to ligand-independent pathway activation. In many other tumor types, ligand-dependent activation of Hh signaling is potentiated through crosstalk with other critical molecular signaling pathways. Among such pathways, RAS/RAF/MEK/ERK, PI3K/AKT/mTOR, EGFR, and Notch are of particular interest because agents that selectively inhibit these pathways are available and can be readily combined with agents such as vismodegib, sonidegib (LDE225), and BMS-833923, which target smoothened-a key Hh pathway regulator. Numerous preclinical studies have revealed the ways in which Hh intersects with each of these pathways, and combination therapies have resulted in improved antitumor efficacy and survival in animal models. Hh also plays an important role in hematopoiesis and in the maintenance of BCR-ABL-driven leukemic stem cells. Thus, combined inhibition of the Hh pathway and BCR-ABL has emerged as a promising potential therapeutic strategy in chronic myeloid leukemia (CML). A number of clinical trials evaluating combinations of Hh inhibitors with other targeted agents are now underway in CML and a variety of solid tumors. This review highlights these trials and summarizes preclinical evidence of crosstalk between Hh and four other actionable pathways-RAS/RAF/MEK/ERK, PI3K/AKT/mTOR, EGFR, and Notch-as well as the role of Hh in the maintenance of BCR-ABL-driven leukemic stem cells.

摘要

hedgehog (Hh) 通路在许多肿瘤中异常激活。在髓母细胞瘤、基底细胞癌和横纹肌肉瘤中,Hh 通路基因的突变导致配体非依赖性通路激活。在许多其他肿瘤类型中,Hh 信号的配体依赖性激活通过与其他关键分子信号通路的串扰而增强。在这些通路中,RAS/RAF/MEK/ERK、PI3K/AKT/mTOR、EGFR 和 Notch 特别引人注目,因为可以使用选择性抑制这些通路的药物,并且可以与维莫德吉、sonidegib (LDE225) 和 BMS-833923 等药物联合使用,这些药物靶向 smoothened——Hh 通路的关键调节剂。许多临床前研究揭示了 Hh 与这些通路中的每一条相互作用的方式,联合治疗在动物模型中导致了抗肿瘤疗效和生存的改善。Hh 还在造血和 BCR-ABL 驱动的白血病干细胞的维持中发挥重要作用。因此,联合抑制 Hh 通路和 BCR-ABL 已成为慢性髓性白血病 (CML) 中一种有前途的潜在治疗策略。目前正在 CML 和各种实体瘤中进行评估 Hh 抑制剂与其他靶向药物联合使用的多项临床试验。这篇综述强调了这些试验,并总结了 Hh 与其他四个可操作通路(RAS/RAF/MEK/ERK、PI3K/AKT/mTOR、EGFR 和 Notch)之间串扰的临床前证据,以及 Hh 在维持 BCR-ABL 驱动的白血病干细胞中的作用。

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