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BH3-Mimetic Drugs: Blazing the Trail for New Cancer Medicines
Delphine Merino1, Gemma L Kelly2, Guillaume Lessene3
1The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia; Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC 3086, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC 3010, Australia.
Abstract:
Defects in apoptotic cell death can promote cancer and impair responses of malignant cells to anti-cancer therapy. Pro-survival BCL-2 proteins prevent apoptosis by keeping the cell death effectors, BAX and BAK, in check. The BH3-only proteins initiate apoptosis by neutralizing the pro-survival BCL-2 proteins. Structural analysis and medicinal chemistry led to the development of small-molecule drugs that mimic the function of the BH3-only proteins to kill cancer cells. The BCL-2 inhibitor venetoclax has been approved for treatment of refractory chronic lymphocytic leukemia and this drug and inhibitors of pro-survival MCL-1 and BCL-XL are being tested in diverse malignancies.
Insights
Cancer cells evade cell death through defects in apoptosis, often by manipulating BCL-2 proteins. Small-molecule drugs targeting these proteins offer a promising strategy for cancer therapy.
Area of Science:
- Molecular Biology
- Oncology
- Drug Discovery
Background:
- Defects in programmed cell death (apoptosis) contribute to cancer development and treatment resistance.
- Pro-survival BCL-2 proteins inhibit apoptosis by sequestering BAX and BAK.
- BH3-only proteins are key initiators of apoptosis, counteracting pro-survival BCL-2 proteins.
Purpose of the Study:
- To explore the development of small-molecule drugs targeting BCL-2 proteins for cancer treatment.
- To investigate strategies for overcoming apoptosis resistance in malignant cells.
Main Methods:
- Utilizing structural analysis and medicinal chemistry to design BH3-mimetic drugs.
- Evaluating the efficacy of BCL-2 inhibitors in preclinical and clinical settings.
Main Results:
- Small-molecule drugs mimicking BH3-only proteins can induce cancer cell death.
- The BCL-2 inhibitor venetoclax is approved for chronic lymphocytic leukemia.
- Ongoing trials are testing BCL-2, MCL-1, and BCL-XL inhibitors in various cancers.
Conclusions:
- Targeting pro-survival BCL-2 family proteins is a viable therapeutic strategy in oncology.
- BH3-mimetic drugs represent a significant advancement in cancer treatment, particularly for resistant malignancies.
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