Rosalind and Morris Goodman Cancer Institute, McGill University, Montreal, QC H3A 1A3, Canada.
Department of Biochemistry, McGill University, Montreal, QC H3G 1Y6, Canada.
Cells. 2024 Jan 25;13(3):218. doi: 10.3390/cells13030218.
Brain tumors represent a heterogeneous group of neoplasms characterized by a high degree of aggressiveness and a poor prognosis. Despite recent therapeutic advances, the treatment of brain tumors, including glioblastoma (GBM), an aggressive primary brain tumor associated with poor prognosis and resistance to therapy, remains a significant challenge. Receptor tyrosine kinases (RTKs) are critical during development and in adulthood. Dysregulation of RTKs through activating mutations and gene amplification contributes to many human cancers and provides attractive therapeutic targets for treatment. Under physiological conditions, the Met RTK, the hepatocyte growth factor/scatter factor (HGF/SF) receptor, promotes fundamental signaling cascades that modulate epithelial-to-mesenchymal transition (EMT) involved in tissue repair and embryogenesis. In cancer, increased Met activity promotes tumor growth and metastasis by providing signals for proliferation, survival, and migration/invasion. Recent clinical genomic studies have unveiled multiple mechanisms by which is genetically altered in GBM, including focal amplification, chromosomal rearrangements generating gene fusions, and a splicing variant mutation (exon 14 skipping, METex14del). Notably, overexpression contributes to chemotherapy resistance in GBM by promoting the survival of cancer stem-like cells. This is linked to distinctive Met-induced pathways, such as the upregulation of DNA repair mechanisms, which can protect tumor cells from the cytotoxic effects of chemotherapy. The development of -targeted therapies represents a major step forward in the treatment of brain tumours. Preclinical studies have shown that -targeted therapies (monoclonal antibodies or small molecule inhibitors) can suppress growth and invasion, enhancing the efficacy of conventional therapies. Early-phase clinical trials have demonstrated promising results with -targeted therapies in improving overall survival for patients with recurrent GBM. However, challenges remain, including the need for patient stratification, the optimization of treatment regimens, and the identification of mechanisms of resistance. This review aims to highlight the current understanding of mechanisms underlying dysregulation in GBM. In addition, it will focus on the ongoing preclinical and clinical assessment of therapies targeting dysregulation in GBM.
脑肿瘤代表了一组具有高度侵袭性和预后不良的异质性肿瘤。尽管最近有了治疗进展,但脑肿瘤的治疗,包括胶质母细胞瘤(GBM),这种侵袭性原发性脑肿瘤与预后不良和对治疗的耐药性有关,仍然是一个重大挑战。受体酪氨酸激酶(RTKs)在发育和成年期都很关键。RTKs 的失调通过激活突变和基因扩增导致许多人类癌症,并为治疗提供了有吸引力的治疗靶点。在生理条件下,Met RTK,即肝细胞生长因子/分散因子(HGF/SF)受体,促进了调节上皮间质转化(EMT)的基本信号级联反应,EMT 涉及组织修复和胚胎发生。在癌症中,Met 活性的增加通过提供增殖、存活和迁移/侵袭的信号,促进肿瘤生长和转移。最近的临床基因组研究揭示了 在 GBM 中发生遗传改变的多种机制,包括局灶性扩增、产生基因融合的染色体重排,以及剪接变异突变(外显子 14 跳跃,METex14del)。值得注意的是, 过表达通过促进癌症干细胞样细胞的存活,导致 GBM 中的化疗耐药。这与独特的 Met 诱导途径有关,例如上调 DNA 修复机制,这可以保护肿瘤细胞免受化疗的细胞毒性作用。针对 的治疗方法的开发是脑肿瘤治疗的重大进展。临床前研究表明,针对 的治疗方法(单克隆抗体或小分子抑制剂)可以抑制生长和侵袭,增强常规治疗的疗效。早期临床试验表明,针对 的治疗方法在提高复发性 GBM 患者的总生存率方面取得了有希望的结果。然而,仍存在挑战,包括患者分层的需要、治疗方案的优化以及耐药机制的确定。本综述旨在强调目前对 GBM 中 失调机制的理解。此外,它将重点介绍针对 GBM 中 失调的临床前和临床评估的进展。
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