The Role of Proteasome Inhibitors in Treating Acute Lymphoblastic Leukaemia

Chun-Fung Sin1, Pui-Hei Marcus Man1

  • 1Department of Pathology, University of Hong Kong, Hong Kong, Hong Kong SAR, China.

Frontiers in Oncology
|January 10, 2022
PubMed

Insights

Proteasome inhibitors show promise for treating relapsed or refractory acute lymphoblastic leukaemia (ALL) in both children and adults. Further research into these agents could improve patient outcomes for this aggressive cancer.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Acute lymphoblastic leukaemia (ALL) is an aggressive cancer with a poor prognosis for relapsed/refractory cases, especially in adults.
  • Bortezomib, a proteasome inhibitor, is approved for other cancers and shows a favorable side effect profile.
  • Existing clinical studies suggest proteasome inhibitors are effective for relapsed/refractory ALL.

Purpose of the Study:

  • To review different proteasome inhibitors and their pharmacological properties.
  • To highlight the mechanism of action of proteasome inhibitors in ALL.
  • To discuss clinical study results of proteasome inhibitors in paediatric and adult ALL.

Main Methods:

  • Literature review of proteasome inhibitors.
  • Analysis of pharmacological properties and mechanisms of action.
  • Synthesis of clinical trial data for paediatric and adult ALL.

Main Results:

  • Proteasome inhibitors represent a promising therapeutic strategy for relapsed/refractory ALL.
  • Understanding their mechanism of action is key to optimizing treatment.
  • Clinical data indicate potential benefits across different age groups.

Conclusions:

  • Proteasome inhibitors are attractive agents for further research in ALL treatment.
  • This review provides insights into their application and mechanism, guiding future studies.
  • Further investigation may lead to improved outcomes for patients with ALL.

Related Concept Videos

The Intrinsic Apoptotic Pathway01:31

The Intrinsic Apoptotic Pathway

Internal cellular stress, such as cellular injury or hypoxia, triggers intrinsic apoptosis. The B-cell lymphoma 2 (Bcl-2) family of proteins are the primary regulators of the intrinsic apoptotic pathway. For example, during DNA damage, checkpoint proteins, such as Ataxia Telangiectasia Mutated (ATM protein) and Checkpoints Factor-2 (Chk2) proteins, are activated. These proteins phosphorylate p53 which further activates pro-apoptotic proteins, such as Bax, Bak, PUMA, and Noxa, and inhibits...
7.0K
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
7.9K
The Proteasome01:13

The Proteasome

Eukaryotic cells can degrade proteins through several pathways. One of the most important among these is the ubiquitin-proteasome pathway. It helps the cell eliminate the misfolded, damaged, or unwarranted cytoplasmic proteins in a highly specific manner.
In this pathway, the target proteins are first tagged with small proteins called ubiquitin. This involves participation of a series of enzymes including— E1 (ubiquitin-activating enzyme), E2 (ubiquitin-conjugating enzyme), and E3...
1.2K
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
5.2K
The Proteasome Structure01:17

The Proteasome Structure

The ubiquitin-proteasome pathway is a well-known mechanism utilized by eukaryotic cells to remove cytoplasmic proteins that are misfolded, damaged, or no longer needed. In this pathway, the protein that needs to be eliminated undergoes a process called ubiquitination, where a chain of ubiquitin molecules is attached to the 48th lysine residue of the target protein. This ubiquitin modification helps the proteasome distinguish between a target protein and a healthy protein.
The proteasome is an...
1.0K