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Published on: May 15, 2019
Resistance acquisition to MDM2 inhibitors
Jindrich Cinatl1, Daniel Speidel, Ian Hardcastle2
1*Institut für Medizinische Virologie, Klinikum der Goethe-Universität, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany.
Abstract:
Various experimental strategies aim to (re)activate p53 signalling in cancer cells. The most advanced clinically are small-molecule inhibitors of the autoregulatory interaction between p53 and MDM2 (murine double minute 2). Different MDM2 inhibitors are currently under investigation in clinical trials. As for other targeted anti-cancer therapy approaches, relatively rapid resistance acquisition may limit the clinical efficacy of MDM2 inhibitors. In particular, MDM2 inhibitors were shown to induce p53 mutations in experimental systems. In the present article, we summarize what is known about MDM2 inhibitors as anti-cancer drugs with a focus on the acquisition of resistance to these compounds.
Insights
MDM2 inhibitors reactivate p53 signaling for cancer treatment but can lead to resistance. This review focuses on how cancer cells acquire resistance to MDM2 inhibitors, potentially limiting their effectiveness.
Area of Science:
- Oncology
- Molecular Biology
- Drug Discovery
Background:
- The p53 protein is a critical tumor suppressor frequently inactivated in cancer.
- MDM2 (murine double minute 2) inhibitors are a promising class of targeted therapies designed to reactivate p53 signaling in cancer cells.
- Several MDM2 inhibitors are currently progressing through clinical trials for various cancer types.
Purpose of the Study:
- To review the current understanding of MDM2 inhibitors as anti-cancer agents.
- To specifically focus on the mechanisms by which cancer cells acquire resistance to MDM2 inhibitors.
- To discuss the implications of resistance for the clinical efficacy of these targeted therapies.
Main Methods:
- Literature review of experimental studies and clinical trial data on MDM2 inhibitors.
- Analysis of reported mechanisms of resistance to MDM2-targeted therapies.
- Synthesis of findings regarding p53 mutations and other resistance pathways.
Main Results:
- MDM2 inhibitors show potential in reactivating p53 and inhibiting tumor growth.
- Acquisition of resistance is a significant challenge, potentially limiting long-term clinical benefit.
- Experimental systems indicate that MDM2 inhibitors can induce p53 mutations, contributing to acquired resistance.
Conclusions:
- MDM2 inhibitors represent an important advancement in targeted cancer therapy.
- Understanding and overcoming resistance mechanisms, such as p53 mutations, are crucial for maximizing the therapeutic potential of MDM2 inhibitors.
- Further research is needed to develop strategies to prevent or circumvent resistance to MDM2 inhibitors in clinical settings.
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