Addressing Transcriptional Dysregulation in Cancer through CDK9 Inhibition
Mohammed A Toure1,2,3, Angela N Koehler1,2,3
1Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States.
Abstract:
Undermining transcriptional addiction, the dependence of cancers on selected transcriptional programs, is critically important for addressing cancers with high unmet clinical need. Cyclin-dependent kinase 9 (CDK9) has long been considered an actionable therapeutic target for modulating transcription in many diseases. This appeal is due to its role in coordinating the biochemical events that regulate RNA polymerase II (RNA Pol II) pause-release state, one that offers a way for attenuating transcriptional dysregulation driven by amplified or overexpressed transcription factors implicated in cancer. However, targeting CDK9 in the clinic has historically proven elusive, a challenge that stems from the often highly intolerable cytotoxicity attributed to its essentiality across many cell lineages and the polypharmacology of the first generation of pan-CDK inhibitors to reach the clinic. A new wave of highly selective molecules progressing through the early stages of clinical evaluation offers renewed hope.
Insights
Targeting Cyclin-dependent kinase 9 (CDK9) offers a strategy to disrupt cancer's reliance on specific gene expression programs. New selective CDK9 inhibitors show promise for treating cancers, overcoming challenges of earlier drugs.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Cancers often depend on specific transcriptional programs, creating a vulnerability.
- Cyclin-dependent kinase 9 (CDK9) regulates RNA polymerase II (RNA Pol II) activity, making it a potential therapeutic target.
- Previous attempts to inhibit CDK9 were hampered by severe toxicity and off-target effects from non-selective inhibitors.
Purpose of the Study:
- To explore the therapeutic potential of targeting CDK9 in cancer treatment.
- To address the unmet clinical need in cancers driven by aberrant transcriptional programs.
- To highlight the promise of newly developed selective CDK9 inhibitors.
Main Methods:
- Review of CDK9's role in transcriptional regulation.
- Analysis of challenges associated with CDK9 inhibition.
- Evaluation of emerging selective CDK9 inhibitor candidates.
Main Results:
- CDK9 is crucial for RNA Pol II pause-release, impacting cancer gene expression.
- Non-selective CDK inhibition leads to significant toxicity and polypharmacology.
- A new generation of selective CDK9 inhibitors is advancing in clinical trials.
Conclusions:
- Targeting CDK9 is a viable strategy for cancers with high unmet need.
- Selective CDK9 inhibition offers a promising therapeutic avenue, mitigating toxicity concerns.
- Further clinical evaluation of selective CDK9 inhibitors is warranted.
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