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Double-Faced Immunological Effects of CDK4/6 Inhibitors on Cancer Treatment: Challenges and Perspectives
Yongqin Liu1,2, Yiying Deng1,2, Chang Yang1,2
1Department of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.
Abstract:
Cyclin-dependent kinases (CDKs) are generally involved in the progression of cell cycle and cell division in normal cells, while abnormal activations of CDKs are deemed to be a driving force for accelerating cell proliferation and tumorigenesis. Therefore, CDKs have become ideal therapeutic targets for cancer treatment. The U.S FDA has approved three CDK4/6 inhibitors (CDK4/6is) for the treatment of patients with hormone receptor-positive (HR+) or human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer, and these drugs showed impressive results in clinics. Besides cell-cycle arrest, there is growing evidence that CDK4/6is exert paradoxical roles on cancer treatment by altering the immune system. Indeed, clinical data showed that CDK4/6is could change the immune system to exert antitumor effects, while these changes also caused tumor resistance to CDK4/6i. However, the molecular mechanism for the regulation of the immune system by CDK4/6is is unclear. In this review, we comprehensively discuss the paradoxical immunological effects of CDK4/6is in cancer treatment, elucidating their anticancer mechanisms through immunomodulatory activity and induction of acquired drug resistance by dysregulating the immune microenvironment. More importantly, we suggest a few strategies including combining CDK4/6is with immunotherapy to overcome drug resistance.
Insights
Cyclin-dependent kinase 4/6 inhibitors (CDK4/6is) treat breast cancer by affecting cell division and the immune system. Understanding these dual roles is key to overcoming drug resistance and improving patient outcomes.
Area of Science:
- Oncology
- Immunology
- Molecular Biology
Background:
- Cyclin-dependent kinases (CDKs) regulate cell cycle progression.
- Abnormal CDK activation drives cancer cell proliferation and tumorigenesis.
- CDK4/6 inhibitors (CDK4/6is) are approved for HR+/HER2- metastatic breast cancer.
Purpose of the Study:
- To review the paradoxical immunological effects of CDK4/6 inhibitors in cancer treatment.
- To elucidate anticancer mechanisms involving immunomodulatory activity.
- To explore how CDK4/6is induce acquired drug resistance by altering the immune microenvironment.
Main Methods:
- Comprehensive literature review of CDK4/6 inhibitors and their immunological effects.
- Analysis of clinical data on CDK4/6 inhibitor-induced immune system changes.
- Discussion of molecular mechanisms underlying CDK4/6 inhibitor-mediated immunomodulation and resistance.
Main Results:
- CDK4/6is exhibit dual roles: promoting cell-cycle arrest and altering the immune system for antitumor effects.
- Immune system modulation by CDK4/6is can paradoxically lead to acquired drug resistance.
- Dysregulation of the tumor immune microenvironment is implicated in resistance to CDK4/6 inhibitors.
Conclusions:
- CDK4/6is have significant immunomodulatory activities with implications for cancer therapy.
- Understanding the complex interplay between CDK4/6is and the immune system is crucial for optimizing treatment strategies.
- Combining CDK4/6is with immunotherapy presents a promising approach to overcome drug resistance.
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