Starling Biosciences, Inc., Coralville, IA 52241, USA.
Cells. 2023 Oct 16;12(20):2460. doi: 10.3390/cells12202460.
Estrogens have been implicated in the pathogenesis of various cancers, with increasing concern regarding the overall rising incidence of disease and exposure to environmental estrogens. Estrogens, both endogenous and environmental, manifest their actions through intracellular and plasma membrane receptors, named ERα, ERβ, and GPER. Collectively, they act to promote a broad transcriptional response that is mediated through multiple regulatory enhancers, including estrogen response elements (EREs), serum response elements (SREs), and cyclic AMP response elements (CREs). Yet, the design and rational assignment of antiestrogen therapy for breast cancer has strictly relied upon an endogenous estrogen-ER binary rubric that does not account for environmental estrogens or GPER. New endocrine therapies have focused on the development of drugs that degrade ER via ER complex destabilization or direct enzymatic ubiquitination. However, these new approaches do not broadly treat all cancer-involved receptors, including GPER. The latter is concerning since GPER is directly associated with tumor size, distant metastases, cancer stem cell activity, and endocrine resistance, indicating the importance of targeting this receptor to achieve a more complete therapeutic response. This review focuses on the critical importance and value of GPER-targeted therapeutics as part of a more holistic approach to the treatment of estrogen-driven malignancies.
雌激素被认为与各种癌症的发病机制有关,人们越来越关注疾病发病率的整体上升和环境雌激素的暴露。雌激素,包括内源性和外源性的,通过细胞内和质膜受体发挥作用,这些受体分别被命名为 ERα、ERβ 和 GPER。它们共同作用,通过多个调节增强子(包括雌激素反应元件 (ERE)、血清反应元件 (SRE) 和环磷酸腺苷反应元件 (CRE))促进广泛的转录反应。然而,用于乳腺癌的抗雌激素治疗的设计和合理分配严格依赖于内源性雌激素-ER 二元规则,该规则并未考虑环境雌激素或 GPER。新的内分泌疗法侧重于开发通过 ER 复合物失稳或直接酶促泛素化来降解 ER 的药物。然而,这些新方法并不能广泛治疗所有涉及癌症的受体,包括 GPER。这令人担忧,因为 GPER 与肿瘤大小、远处转移、癌症干细胞活性和内分泌抵抗直接相关,这表明靶向该受体以实现更完全的治疗反应的重要性。这篇综述重点介绍了针对 GPER 的治疗作为治疗雌激素驱动的恶性肿瘤的更全面方法的一部分的重要性和价值。