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靶向 RAS/RAF/MAPK 通路治疗癌症:从机制到临床研究。

Targeting the RAS/RAF/MAPK pathway for cancer therapy: from mechanism to clinical studies.

机构信息

Department of Biochemistry and Convergence Medical Sciences and Institute of Medical Science, Gyeongsang National University, College of Medicine, Jinju, South Korea.

Department of Anatomy and Convergence Medical Sciences and Institute of Medical Science, Gyeongsang National University, College of Medicine, Jinju, South Korea.

出版信息

Signal Transduct Target Ther. 2023 Dec 18;8(1):455. doi: 10.1038/s41392-023-01705-z.


DOI:10.1038/s41392-023-01705-z
PMID:38105263
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10725898/
Abstract

Metastatic dissemination of solid tumors, a leading cause of cancer-related mortality, underscores the urgent need for enhanced insights into the molecular and cellular mechanisms underlying metastasis, chemoresistance, and the mechanistic backgrounds of individuals whose cancers are prone to migration. The most prevalent signaling cascade governed by multi-kinase inhibitors is the mitogen-activated protein kinase (MAPK) pathway, encompassing the RAS-RAF-MAPK kinase (MEK)-extracellular signal-related kinase (ERK) pathway. RAF kinase is a primary mediator of the MAPK pathway, responsible for the sequential activation of downstream targets, such as MEK and the transcription factor ERK, which control numerous cellular and physiological processes, including organism development, cell cycle control, cell proliferation and differentiation, cell survival, and death. Defects in this signaling cascade are associated with diseases such as cancer. RAF inhibitors (RAFi) combined with MEK blockers represent an FDA-approved therapeutic strategy for numerous RAF-mutant cancers, including melanoma, non-small cell lung carcinoma, and thyroid cancer. However, the development of therapy resistance by cancer cells remains an important barrier. Autophagy, an intracellular lysosome-dependent catabolic recycling process, plays a critical role in the development of RAFi resistance in cancer. Thus, targeting RAF and autophagy could be novel treatment strategies for RAF-mutant cancers. In this review, we delve deeper into the mechanistic insights surrounding RAF kinase signaling in tumorigenesis and RAFi-resistance. Furthermore, we explore and discuss the ongoing development of next-generation RAF inhibitors with enhanced therapeutic profiles. Additionally, this review sheds light on the functional interplay between RAF-targeted therapies and autophagy in cancer.

摘要

实体瘤的转移扩散是癌症相关死亡的主要原因,这突显了深入了解转移、化学抗性以及癌症易转移个体的机制背景的分子和细胞机制的迫切需要。受多激酶抑制剂调控的最常见信号级联反应是丝裂原活化蛋白激酶(MAPK)途径,包括 RAS-RAF-MAPK 激酶(MEK)-细胞外信号相关激酶(ERK)途径。RAF 激酶是 MAPK 途径的主要介质,负责下游靶标的顺序激活,如 MEK 和转录因子 ERK,它们控制着许多细胞和生理过程,包括生物发育、细胞周期控制、细胞增殖和分化、细胞存活和死亡。该信号级联反应的缺陷与癌症等疾病有关。RAF 抑制剂(RAFi)与 MEK 阻滞剂的联合使用代表了 FDA 批准的针对许多 RAF 突变癌症的治疗策略,包括黑色素瘤、非小细胞肺癌和甲状腺癌。然而,癌细胞对治疗的耐药性的发展仍然是一个重要的障碍。自噬是一种依赖溶酶体的细胞内分解代谢回收过程,在癌症中 RAFi 耐药性的发展中起着关键作用。因此,靶向 RAF 和自噬可能是 RAF 突变癌症的新治疗策略。在这篇综述中,我们深入探讨了 RAF 激酶信号在肿瘤发生和 RAFi 耐药性中的机制见解。此外,我们探讨并讨论了具有增强治疗谱的下一代 RAF 抑制剂的正在开发情况。此外,本综述还揭示了 RAF 靶向治疗与癌症中自噬之间的功能相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/08d6f5f6ef6b/41392_2023_1705_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/6f3f1db3964b/41392_2023_1705_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/a590b41216f9/41392_2023_1705_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/6578c7ba36cc/41392_2023_1705_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/65f2939a0152/41392_2023_1705_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/c3615113b43c/41392_2023_1705_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/4b50de232e8d/41392_2023_1705_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/64c97f9c977a/41392_2023_1705_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/fc3249e62ef4/41392_2023_1705_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/08d6f5f6ef6b/41392_2023_1705_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/6f3f1db3964b/41392_2023_1705_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/a590b41216f9/41392_2023_1705_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/6578c7ba36cc/41392_2023_1705_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/65f2939a0152/41392_2023_1705_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/c3615113b43c/41392_2023_1705_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/4b50de232e8d/41392_2023_1705_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/64c97f9c977a/41392_2023_1705_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/fc3249e62ef4/41392_2023_1705_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a3/10725898/08d6f5f6ef6b/41392_2023_1705_Fig9_HTML.jpg

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本文引用的文献

[1]
Dabrafenib plus Trametinib in Pediatric Glioma with V600 Mutations.

N Engl J Med. 2023-9-21

[2]
Research progress of nanovaccine in anti-tumor immunotherapy.

Front Oncol. 2023-8-24

[3]
Pharmacokinetics of the KRAS inhibitor adagrasib is limited by CYP3A and ABCB1, and influenced by binding to mouse plasma carboxylesterase 1c.

Biomed Pharmacother. 2023-10

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N Engl J Med. 2023-7-13

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