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人类癌症中的RET信号通路与RET抑制剂

RET signaling pathway and RET inhibitors in human cancer.

作者信息

Regua Angelina T, Najjar Mariana, Lo Hui-Wen

机构信息

Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, United States.

Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States.

出版信息

Front Oncol. 2022 Jul 25;12:932353. doi: 10.3389/fonc.2022.932353. eCollection 2022.

Abstract

Rearranged during transfection (RET) receptor tyrosine kinase was first identified over thirty years ago as a novel transforming gene. Since its discovery and subsequent pathway characterization, RET alterations have been identified in numerous cancer types and are most prevalent in thyroid carcinomas and non-small cell lung cancer (NSCLC). In other tumor types such as breast cancer and salivary gland carcinomas, RET alterations can be found at lower frequencies. Aberrant RET activity is associated with poor prognosis of thyroid and lung carcinoma patients, and is strongly correlated with increased risk of distant metastases. RET aberrations encompass a variety of genomic or proteomic alterations, most of which confer constitutive activation of RET. Activating RET alterations, such as point mutations or gene fusions, enhance activity of signaling pathways downstream of RET, namely PI3K/AKT, RAS/RAF, MAPK, and PLCγ pathways, to promote cell proliferation, growth, and survival. Given the important role that mutant RET plays in metastatic cancers, significant efforts have been made in developing inhibitors against RET kinase activity. These efforts have led to FDA approval of Selpercatinib and Pralsetinib for NSCLC, as well as, additional selective RET inhibitors in preclinical and clinical testing. This review covers the current biological understanding of RET signaling, the impact of RET hyperactivity on tumor progression in multiple tumor types, and RET inhibitors with promising preclinical and clinical efficacy.

摘要

转染重排(RET)受体酪氨酸激酶在三十多年前首次被鉴定为一种新型转化基因。自其发现及随后的信号通路特征分析以来,RET改变已在多种癌症类型中被发现,在甲状腺癌和非小细胞肺癌(NSCLC)中最为常见。在其他肿瘤类型如乳腺癌和唾液腺癌中,RET改变的发生率较低。RET异常激活与甲状腺癌和肺癌患者的不良预后相关,且与远处转移风险增加密切相关。RET畸变包括多种基因组或蛋白质组改变,其中大多数导致RET的组成性激活。激活型RET改变,如点突变或基因融合,增强了RET下游信号通路的活性,即PI3K/AKT、RAS/RAF、MAPK和PLCγ通路,以促进细胞增殖、生长和存活。鉴于突变型RET在转移性癌症中的重要作用,人们在开发针对RET激酶活性的抑制剂方面付出了巨大努力。这些努力已导致塞尔帕替尼和普拉替尼被FDA批准用于治疗NSCLC,以及其他处于临床前和临床试验阶段的选择性RET抑制剂。本综述涵盖了目前对RET信号传导的生物学理解、RET过度激活对多种肿瘤类型肿瘤进展的影响,以及具有良好临床前和临床疗效的RET抑制剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b348/9359433/d3ed6e6978f3/fonc-12-932353-g001.jpg

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