, Volume 27, Issue 2, pp 185-198
Date: 11 Mar 2009

TNF-α and its inhibitors in cancer

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Abstract

Tumor necrosis factor (TNF)-α is implicated in the same time in apoptosis and in cell proliferation. TNF-α not only acts as pro-inflammatory cytokine conducing to wide spectrum of human diseases including inflammatory diseases, but can also induce tumor development. The molecular mechanisms of TNF-α functions have been intensively investigated. In this review we covered TNF-α, the molecule, its signaling pathway, and its therapeutic functions. We provide a particular insight in its paradoxical role in tumor promotion and in its use as anti-tumor agent. This review considers also the recent findings regarding TNF-α inhibitors, their pharmacokinetics, and their pharmacodynamics. Six TNF-α inhibitors have been considered here: Infliximab, Adalimumab, Golimumab, CDP870, CDP571, Etanercept, and Thalidomide. We discussed the clinical relevance of their functions in treatment of several diseases such as advanced inflammatory rheumatic and bowel disease, with a focus in cancer treatment. Targeting TNF-α by these drugs has many side effects like malignancies development, and the long-term sequels are not very well explored. Their efficacy and their safety were discussed, underscoring the necessity of close patients monitoring and of their caution use.