Abstract

For over three decades, a mainstay and goal of clinical oncology has been the development of therapies promoting the effective elimination of cancer cells by apoptosis. This programmed cell death process is mediated by several signalling pathways (referred to as intrinsic and extrinsic) triggered by multiple factors, including cellular stress, DNA damage and immune surveillance. The interaction of apoptosis pathways with other signalling mechanisms can also affect cell death. The clinical translation of effective pro-apoptotic agents involves drug discovery studies (addressing the bioavailability, stability, tumour penetration, toxicity profile in non-malignant tissues, drug interactions and off-target effects) as well as an understanding of tumour biology (including heterogeneity and evolution of resistant clones). While tumour cell death can result in response to therapy, the selection, growth and dissemination of resistant cells can ultimately be fatal. In this Review, we present the main apoptosis pathways and other signalling pathways that interact with them, and discuss actionable molecular targets, therapeutic agents in clinical translation and known mechanisms of resistance to these agents.

Keywords

ApoptosisProgrammed cell deathMedicineCancer researchDNA damageCancerCancer cellTranslation (biology)Immune systemBioinformaticsImmunologyBiologyDNAGeneticsInternal medicine

MeSH Terms

ApoptosisDNA DamageDrug ResistanceNeoplasmHumansMolecular Targeted TherapyNeoplasmsSignal Transduction

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Publication Info

Year
2020
Type
review
Volume
17
Issue
7
Pages
395-417
Citations
2396
Access
Closed

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Cite This

Benedito A. Carneiro, Wafik S. El‐Deiry (2020). Targeting apoptosis in cancer therapy. Nature Reviews Clinical Oncology , 17 (7) , 395-417. https://doi.org/10.1038/s41571-020-0341-y

Identifiers

DOI
10.1038/s41571-020-0341-y
PMID
32203277
PMCID
PMC8211386

Data Quality

Data completeness: 86%