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Strategies for multiple signalling inhibition
G Tortora1, R Bianco, G Daniele
1Department of Molecular and Clinical Endocrinology and Oncology, University of Naples "Federico II", Naples, Italy. tortora@unina.it
Abstract:
Cancer cells hyperactivate signalling molecules, including EGFR, Akt and the angiogenic factor VEGF to escape apoptosis, thus contributing also to resistance to treatment. While single signalling inhibitors have produced limited advantages in clinical trials, their combination with conventional treatments is more effective; however, the rate of responses is generally around 20%. A major limitation is represented by the activation of escape pathways, due to an intensive cross-talk and redundancy of signals in the transduction network. A novel and more rational approach is the combination of multiple signalling inhibitors, according to the molecular context of disease, in combination with selected conventional treatments.
Insights
Targeting cancer's signaling pathways with multiple inhibitors, alongside conventional treatments, offers a more effective strategy than single-drug approaches for overcoming treatment resistance.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Signaling
Background:
- Cancer cells evade apoptosis and treatment resistance by hyperactivating signaling molecules like Epidermal Growth Factor Receptor (EGFR), Akt, and Vascular Endothelial Growth Factor (VEGF).
- Single-agent signaling inhibitors show limited clinical efficacy, with response rates around 20% when combined with conventional treatments.
- Intensive cross-talk and signal redundancy within cellular transduction networks activate escape pathways, posing a major limitation to current therapies.
Purpose of the Study:
- To propose a novel therapeutic strategy for cancer treatment.
- To address the limitations of single-target inhibition in overcoming cancer cell resistance.
- To investigate a more rational combination approach for cancer therapy.
Main Methods:
- Review of current cancer signaling pathways and therapeutic strategies.
- Analysis of the role of EGFR, Akt, and VEGF in cancer cell survival and resistance.
- Conceptualization of combination therapies involving multiple signaling inhibitors.
Main Results:
- Single signaling inhibitors combined with conventional treatments yield limited response rates.
- Cancer cells exhibit complex signaling networks with cross-talk and redundancy, leading to escape pathways.
- Combination of multiple signaling inhibitors, tailored to the disease's molecular context, shows promise.
Conclusions:
- A multi-targeted signaling inhibition strategy, combined with conventional treatments and personalized to the molecular profile of the cancer, is a rational and potentially more effective approach.
- Overcoming therapeutic resistance requires addressing the intricate signaling networks within cancer cells.
- Future cancer therapies should focus on combinatorial approaches targeting multiple pathways simultaneously.
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