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p53 作为癌症治疗的靶点。

p53 as a target for the treatment of cancer.

出版信息

Cancer Treat Rev. 2014 Dec;40(10):1153-60. doi: 10.1016/j.ctrv.2014.10.004.

Abstract

TP53 (p53) is the most frequently mutated gene in cancer, being altered in approximately 50% of human malignancies. In most, if not all, cancers lacking mutation, wild-type (WT) p53 is inactivated by interaction with cellular (MDM2/MDM4) or viral proteins, leading to its degradation. Because of its near universal alteration in cancer, p53 is an attractive target for the development of new targeted therapies for this disease. However, until recently, p53 was widely regarded as ‘‘undruggable’’. This situation has now changed, as several compounds have become available that can restore wild-type properties to mutant p53 (e.g., PRIMA-1 and PRIMA-1MET). Other compounds are available that prevent the binding of MDM2/MDM4 to WT p53, thereby blocking its degradation (e.g., nutlins). Anti-mutant p53 compounds are potentially most useful in cancers with a high prevalence of p53 mutations. These include difficult-totreat tumors such as high grade serous ovarian cancer, triple-negative breast cancer and squamous lung cancer. MDM2/4 antagonists, on the other hand, are likely to be efficacious in malignancies in which MDM2 or MDM4 is overexpressed such as sarcomas, neuroblastomas and specific childhood leukemias. Presently, early clinical trials are ongoing evaluating the anti-mutant p53 agent, PRIMA-1MET, and specific MDM2–p53 nutlin antagonists.

摘要

TP53(p53)是癌症中最常发生突变的基因,大约有 50%的人类恶性肿瘤发生改变。在大多数(如果不是全部)没有突变的癌症中,野生型(WT)p53 与细胞(MDM2/MDM4)或病毒蛋白相互作用而失活,导致其降解。由于 p53 在癌症中几乎普遍发生改变,因此它是开发针对这种疾病的新型靶向治疗方法的有吸引力的靶标。然而,直到最近,p53 仍被广泛认为是“不可成药的”。这种情况现在已经改变,因为已经有几种化合物可以使突变型 p53 恢复野生型特性(例如,PRIMA-1 和 PRIMA-1MET)。还有其他一些化合物可防止 MDM2/MDM4 与 WT p53 结合,从而阻止其降解(例如,nutlins)。抗突变型 p53 化合物在 p53 突变率较高的癌症中可能最有用。这些癌症包括治疗困难的肿瘤,如高级别浆液性卵巢癌、三阴性乳腺癌和鳞状肺癌。另一方面,MDM2/4 拮抗剂可能对 MDM2 或 MDM4 过表达的恶性肿瘤有效,如肉瘤、神经母细胞瘤和特定的儿童白血病。目前,正在进行早期临床试验,以评估抗突变型 p53 药物 PRIMA-1MET 和特定的 MDM2-p53 nutlin 拮抗剂。

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