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Published on: September 19, 2018
Should we keep rocking? Portraits from targeting Rho kinases in cancer
Graziella Ribeiro de Sousa1, Gabriela Maciel Vieira1, Pablo Ferreira das Chagas1
1Ribeirão Preto Medical School, University of São Paulo, Brazil.
Abstract:
Cancer targeted therapy, either alone or in combination with conventional chemotherapy, could allow the survival of patients with neoplasms currently considered incurable. In recent years, the dysregulation of the Rho-associated coiled-coil kinases (ROCK1 and ROCK2) has been associated with increased metastasis and poorer patient survival in several tumor types, and due to their essential roles in regulating the cytoskeleton, have gained popularity and progressively been researched as targets for the development of novel anti-cancer drugs. Nevertheless, in a pediatric scenario, the influence of both isoforms on prognosis remains a controversial issue. In this review, we summarize the functions of ROCKs, compile their roles in human cancer and their value as prognostic factors in both, adult and pediatric cancer. Moreover, we provide the up-to-date advances on their pharmacological inhibition in pre-clinical models and clinical trials. Alternatively, we highlight and discuss detrimental effects of ROCK inhibition provoked not only by the action on off-targets, but most importantly, by pro-survival effects on cancer stem cells, dormant cells, and circulating tumor cells, along with cell-context or microenvironment-dependent contradictory responses. Together these drawbacks represent a risk for cancer cell dissemination and metastasis after anti-ROCK intervention, a caveat that should concern scientists and clinicians.
Insights
Rho-associated coiled-coil kinases (ROCK1 and ROCK2) are promising cancer drug targets. However, ROCK inhibition may paradoxically promote cancer spread and metastasis, posing risks in clinical applications.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Rho-associated coiled-coil kinases (ROCK1 and ROCK2) regulate cytoskeleton and are implicated in cancer metastasis.
- ROCK dysregulation correlates with poorer survival in various cancers, making them attractive therapeutic targets.
Purpose of the Study:
- To review ROCK functions, roles in adult and pediatric cancers, and prognostic value.
- To summarize advances in ROCK pharmacological inhibition and discuss potential detrimental effects.
Main Methods:
- Literature review of ROCK functions, cancer roles, prognostic significance, and therapeutic strategies.
- Analysis of pre-clinical and clinical data on ROCK inhibitors.
- Discussion of off-target effects and pro-survival impacts of ROCK inhibition.
Main Results:
- ROCKs are crucial for cancer metastasis and survival, with controversial prognostic roles in pediatric cancers.
- Pharmacological inhibition of ROCKs shows promise in pre-clinical models but presents significant challenges.
- ROCK inhibition can promote cancer stem cell survival, dormancy, and dissemination, alongside context-dependent adverse effects.
Conclusions:
- ROCK inhibitors offer potential for cancer therapy but require careful consideration of risks.
- Detrimental effects like enhanced metastasis and resistance necessitate further research for safe and effective anti-ROCK strategies.
- Understanding ROCKs' complex roles is critical for developing novel cancer treatments, especially in pediatric oncology.
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