Abstract
Programmed cell death, or apoptosis, is a cell-autonomous mechanism to restrict deviation from normal cellular function. Central to this mechanism are Bcl-2 proteins, which monitor normal cellular function to define apoptotic fate by surveying, integrating, and decoding multiple survival and proapoptotic signals from the intra and extra cellular environment. Escape from these restrictive mechanisms is essential to accommodate the cellular changes driving tumor establishment and development. To do so, many of the factors promoting tumorigenesis, such as genetic lesions, hypoxia, p53 mutations and oncogene activation, gain control over the main apoptotic pathway to promote cell survival. For this reason, the apoptotic pathway is the focus of remarkable interest for targeted cancer therapy development. However, as apoptosis evasion is a tumor promoting factor itself, the results of first therapeutic targeting attempts reveal that these targets pose drawbacks similar to the exhibited by classic oncogenic targets, including the rapid development of resistance through high mutation rate, intra and inter tumor heterogeneity and narrow effective range.
In addition to tumor promoting pathways, apoptosis evasion is fostered by factors secondary to transformation and tumor development. These factors, such as changes in the interaction with the extracellular environment and metabolism, have received less attention because of their underestimated role in transformation but might prove to be fruitful avenues for intervention as they are common to many tissues and affect apoptotic fate under the influence of reduced oncogenic pressure. The significance of these factors with respect to apoptosis evasion and their potential impact for therapy development are discussed.
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This work was supported by an award from the American Heart Association and by grant number K22CA127136 from the National Cancer Institute.
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Werner, E. (2009). How Cancer Cells Escape Death. In: Sarangarajan, R., Apte, S. (eds) Cellular Respiration and Carcinogenesis. Humana Press. https://doi.org/10.1007/978-1-59745-435-3_12
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