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Published on: December 30, 2025
Pharmacological reactivation of mutant p53: from protein structure to the cancer patient
1Department of Oncology-Pathology, Cancer Center Karolinska, Karolinska Institutet, Stockholm, Sweden. klas.wiman@ki.se
Abstract:
The p53 tumor suppressor pathway blocks tumor development by triggering apoptosis or cellular senescence in response to oncogenic stress. A large fraction of human tumors carry p53 mutations that disrupt DNA binding of p53 and transcriptional regulation of target genes. Reconstitution of wild-type p53 in vivo triggers rapid elimination of tumors. Therefore, pharmacological reactivation of mutant p53 is a promising strategy for novel cancer therapy. Several approaches for identification of small molecules that target mutant p53 have been applied, including rational design and screening of chemical libraries. The compound PhiKan083 binds with high affinity to a crevice created by the Y220C mutation in p53 and stabilizes the mutant protein. The compound PRIMA-1 (p53 reactivation and induction of massive apoptosis) restores wild-type conformation to mutant p53 by binding to the core and induces apoptosis in human tumor cells. The PRIMA-1 analog APR-246 is currently tested in a clinical trial. Successful development of mutant p53-reactivating anticancer drugs should have a major impact on the treatment of cancer.
Insights
Restoring function to mutant p53 protein, a common cancer driver, offers a promising new therapeutic strategy. Compounds like PRIMA-1 and APR-246 reactivate mutant p53, inducing cancer cell death.
Area of Science:
- Oncology
- Molecular Biology
- Drug Discovery
Background:
- The p53 tumor suppressor pathway is crucial for preventing cancer by inducing apoptosis or senescence.
- Mutations in p53 are prevalent in human cancers, impairing its tumor-suppressive functions.
- Restoring wild-type p53 activity in tumors is a viable therapeutic strategy.
Purpose of the Study:
- To explore pharmacological reactivation of mutant p53 as a novel cancer therapy.
- To identify and characterize small molecules that can restore p53 function.
Main Methods:
- Screening of chemical libraries and rational drug design were employed.
- The compound PhiKan083 was identified, binding to the Y220C p53 mutation.
- PRIMA-1 was found to restore wild-type p53 conformation and induce apoptosis.
Main Results:
- PhiKan083 stabilizes mutant p53 by binding to a specific mutation site.
- PRIMA-1 restores wild-type p53 conformation, leading to apoptosis in tumor cells.
- The PRIMA-1 analog APR-246 is undergoing clinical trials.
Conclusions:
- Pharmacological reactivation of mutant p53 is a promising anticancer strategy.
- Small molecules targeting mutant p53 hold potential for significant impact in cancer treatment.
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