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靶向DNA损伤反应和DNA修复途径以增强结直肠癌的放射敏感性

Targeting the DNA Damage Response and DNA Repair Pathways to Enhance Radiosensitivity in Colorectal Cancer.

作者信息

Deng Siyao, Vlatkovic Tijana, Li Moying, Zhan Tianzuo, Veldwijk Marlon R, Herskind Carsten

机构信息

Cellular and Molecular Radiation Oncology Lab, Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.

Department of Medicine II, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.

出版信息

Cancers (Basel). 2022 Oct 5;14(19):4874. doi: 10.3390/cancers14194874.

Abstract

Radiotherapy is an important component of current treatment options for colorectal cancer (CRC). It is either applied as neoadjuvant radiotherapy to improve local disease control in rectal cancers or for the treatment of localized metastatic lesions of CRC. DNA double-strand breaks (DSBs) are the major critical lesions contributing to ionizing radiation (IR)-induced cell death. However, CRC stem cells promote radioresistance and tumor cell survival through activating cell-cycle checkpoints to trigger the DNA damage response (DDR) and DNA repair after exposure to IR. A promising strategy to overcome radioresistance is to target the DDR and DNA repair pathways with drugs that inhibit activated cell-cycle checkpoint proteins, thereby improving the sensitivity of CRC cells to radiotherapy. In this review, we focus on the preclinical studies and advances in clinical trials of DNA-dependent protein kinase catalytic subunit (DNA-PKcs), ataxia telangiectasia mutated (ATM), ataxia telangiectasia and Rad3-related kinase (ATR), checkpoint kinase 1 (CHK1), checkpoint kinase 2 (CHK2), WEE1 and poly (ADP-ribose) polymerase 1 (PARP1) kinase inhibitors in CRC. Importantly, we also discuss the selective radiosensitization of CRC cells provided by synthetic lethality of these inhibitors and the potential for widening the therapeutic window by targeting the DDR and DNA repair pathways in combination with radiotherapy and immunotherapy.

摘要

放射治疗是目前结直肠癌(CRC)治疗方案的重要组成部分。它既可以作为新辅助放疗用于改善直肠癌的局部疾病控制,也可用于治疗CRC的局部转移性病变。DNA双链断裂(DSB)是导致电离辐射(IR)诱导细胞死亡的主要关键损伤。然而,CRC干细胞通过激活细胞周期检查点来触发DNA损伤反应(DDR)和暴露于IR后的DNA修复,从而促进放射抗性和肿瘤细胞存活。一种有前景的克服放射抗性的策略是用抑制激活的细胞周期检查点蛋白的药物靶向DDR和DNA修复途径,从而提高CRC细胞对放疗的敏感性。在本综述中,我们重点关注DNA依赖性蛋白激酶催化亚基(DNA-PKcs)、共济失调毛细血管扩张症突变基因(ATM)、共济失调毛细血管扩张症和Rad3相关激酶(ATR)、检查点激酶1(CHK1)、检查点激酶2(CHK2)、WEE1和聚(ADP-核糖)聚合酶1(PARP1)激酶抑制剂在CRC中的临床前研究和临床试验进展。重要的是,我们还讨论了这些抑制剂的合成致死性为CRC细胞提供的选择性放射增敏作用,以及通过靶向DDR和DNA修复途径与放疗和免疫疗法联合使用来扩大治疗窗口的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a66f/9561988/4b710d9c59c3/cancers-14-04874-g001.jpg

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