Laboratory of Experimental Oncology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA.
Int J Mol Sci. 2023 Nov 15;24(22):16346. doi: 10.3390/ijms242216346.
Sarcomas are heterogeneous bone and soft tissue cancers representing the second most common tumor type in children and adolescents. Histology and genetic profiling discovered more than 100 subtypes, which are characterized by peculiar molecular vulnerabilities. However, limited therapeutic options exist beyond standard therapy and clinical benefits from targeted therapies were observed only in a minority of patients with sarcomas. The rarity of these tumors, paucity of actionable mutations, and limitations in the chemical composition of current targeted therapies hindered the use of these approaches in sarcomas. Targeted protein degradation (TPD) is an innovative pharmacological modality to directly alter protein abundance with promising clinical potential in cancer, even for undruggable proteins. TPD is based on the use of small molecules called degraders or proteolysis-targeting chimeras (PROTACs), which trigger ubiquitin-dependent degradation of protein of interest. In this review, we will discuss major features of PROTAC and PROTAC-derived genetic systems for target validation and cancer treatment and focus on the potential of these approaches to overcome major issues connected to targeted therapies in sarcomas, including drug resistance, target specificity, and undruggable targets. A deeper understanding of these strategies might provide new fuel to drive molecular and personalized medicine to sarcomas.
肉瘤是一种异质性的骨和软组织癌症,是儿童和青少年中第二常见的肿瘤类型。组织学和基因分析发现了超过 100 种亚型,这些亚型的特点是具有独特的分子弱点。然而,除了标准疗法之外,治疗选择有限,而且只有少数肉瘤患者从靶向治疗中获益。这些肿瘤的罕见性、可操作性突变的缺乏以及当前靶向疗法的化学成分限制,阻碍了这些方法在肉瘤中的应用。靶向蛋白降解(TPD)是一种创新的药理学模式,可直接改变蛋白质丰度,在癌症治疗方面具有有前景的临床潜力,即使是针对不可成药的蛋白质也是如此。TPD 基于使用称为降解剂或蛋白水解靶向嵌合体(PROTAC)的小分子,这些小分子触发靶蛋白的泛素依赖性降解。在这篇综述中,我们将讨论 PROTAC 和 PROTAC 衍生的遗传系统在靶标验证和癌症治疗中的主要特点,并重点介绍这些方法克服肉瘤中靶向治疗相关主要问题的潜力,包括耐药性、靶标特异性和不可成药靶标。对这些策略的更深入了解可能为推动肉瘤的分子和个性化医学提供新的动力。
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