Karami Fath Mohsen, Najafiyan Behnam, Morovatshoar Reza, Khorsandi Mahdieh, Dashtizadeh Adib, Kiani Arash, Farzam Farnoosh, Kazemi Kimia Sadat, Nabi Afjadi Mohsen
Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran.
Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Naunyn Schmiedebergs Arch Pharmacol. 2025 Feb;398(2):1403-1431. doi: 10.1007/s00210-024-03444-6. Epub 2024 Sep 21.
Cancer is a complex disease driven by multiple genetic changes, including mutations in oncogenes, tumor suppressor genes, DNA repair genes, and genes involved in cancer metabolism. Synthetic lethality (SL) is a promising approach in cancer research and treatment, where the simultaneous dysfunction of specific genes or pathways causes cell death. By targeting vulnerabilities created by these dysfunctions, SL therapies selectively kill cancer cells while sparing normal cells. SL therapies, such as PARP inhibitors, WEE1 inhibitors, ATR and ATM inhibitors, and DNA-PK inhibitors, offer a distinct approach to cancer treatment compared to conventional targeted therapies. Instead of directly inhibiting specific molecules or pathways, SL therapies exploit genetic or molecular vulnerabilities in cancer cells to induce selective cell death, offering benefits such as targeted therapy, enhanced treatment efficacy, and minimized harm to healthy tissues. SL therapies can be personalized based on each patient's unique genetic profile and combined with other treatment modalities to potentially achieve synergistic effects. They also broaden the effectiveness of treatment across different cancer types, potentially overcoming drug resistance and improving patient outcomes. This review offers an overview of the current understanding of SL mechanisms, advancements, and challenges, as well as the preclinical and clinical development of SL. It also discusses new directions and opportunities for utilizing SL in targeted therapy for anticancer treatment.
癌症是一种由多种基因变化驱动的复杂疾病,包括癌基因、肿瘤抑制基因、DNA修复基因以及参与癌症代谢的基因发生突变。合成致死(SL)是癌症研究和治疗中一种很有前景的方法,其中特定基因或通路的同时功能障碍会导致细胞死亡。通过针对这些功能障碍所产生的脆弱性,SL疗法可选择性地杀死癌细胞,同时使正常细胞免受损害。与传统的靶向疗法相比,SL疗法,如PARP抑制剂、WEE1抑制剂、ATR和ATM抑制剂以及DNA-PK抑制剂,为癌症治疗提供了一种独特的方法。SL疗法并非直接抑制特定分子或通路,而是利用癌细胞中的基因或分子脆弱性来诱导选择性细胞死亡,具有靶向治疗、提高治疗效果以及对健康组织损害最小化等优点。SL疗法可根据每位患者独特的基因谱进行个性化定制,并与其他治疗方式联合使用,以潜在地实现协同效应。它们还拓宽了不同癌症类型的治疗效果,有可能克服耐药性并改善患者预后。本综述概述了目前对SL机制、进展和挑战的理解,以及SL的临床前和临床开发情况。它还讨论了在抗癌治疗的靶向治疗中利用SL的新方向和机会。