Abstract

Simple SummaryNeuroblastoma is the most common extra-cranial solid tumor of childhood arising from the developing sympathetic neuroblast. Despite intense multimodal therapy, more than half of patients with high-risk neuroblastoma relapse with incurable disease. The Yes-Associated Protein (YAP) has been shown to play a critical role in many types of cancers, including neuroblastoma. YAP has also been recently highlighted as an important regulator of the tumor microenvironment (TME) that can affect cancer growth and response to therapies. Here, we focus on YAP and its role in neuroblastoma and the TME that underscores the therapeutic potential of inhibiting YAP in this highly aggressive pediatric solid tumor.Neuroblastoma is the most common extra-cranial pediatric solid tumor that accounts for more than 15% of childhood cancer-related deaths. High risk neuroblastomas that recur during or after intense multimodal therapy have a <5% chance at a second sustained remission or cure. The solid tumor microenvironment (TME) has been increasingly recognized to play a critical role in cancer progression and resistance to therapy, including in neuroblastoma. The Yes-Associated Protein (YAP) in the Hippo pathway can regulate cancer proliferation, tumor initiation, and therapy response in many cancer types and as such, its role in the TME has gained interest. In this review, we focus on YAP and its role in neuroblastoma and further describe its demonstrated and potential effects on the neuroblastoma TME. We also discuss the therapeutic strategies for inhibiting YAP in neuroblastoma.

Highlights

  • Neuroblastoma is the most common extra-cranial solid tumor of childhood arising from the developing sympathetic nervous system [1], with approximately 800 cases per year identified in the United States [2]

  • We have demonstrated that when SK-N-AS cells with stable Yes-Associated Protein (YAP) knockdown were injected subcutaneously into immunodeficient Nod scid gamma (NSG) mice, there was a significant delay in early tumor formation compared to control YAP-expressing SK-N-AS xenografts [51]

  • We have provided a comprehensive summary of the oncogenic role for YAP in neuroblastoma

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Summary

A New Player in Neuroblastoma

Simple Summary: Neuroblastoma is the most common extra-cranial solid tumor of childhood arising from the developing sympathetic neuroblast. More than half of patients with high-risk neuroblastoma relapse with incurable disease. The Yes-Associated Protein (YAP) has been shown to play a critical role in many types of cancers, including neuroblastoma. YAP has been recently highlighted as an important regulator of the tumor microenvironment (TME) that can affect cancer growth and response to therapies. We focus on YAP and its role in neuroblastoma and the TME that underscores the therapeutic potential of inhibiting YAP in this highly aggressive pediatric solid tumor

Introduction
YAP and Its Role in High-Risk Neuroblastoma
Tumorigenesis
Cell Proliferation
Tumor Growth
Metastasis
Therapy Resistance
Cytotoxic Therapy Resistance Imparted by YAP Differs In Vitro Versus In Vivo
Tyrosine Kinase Inhibitor Resistance Due to YAP
Mesenchymal Properties
Neurosphere Formation
Mesenchymal Phenotype
Tumor Environmental Stress-Induced Apoptosis
Hypoxia and Angiogenesis
Extracellular Matrix Remodeling
Immune Milieu
Future Investigations
Therapeutic Targeting of YAP in Neuroblastoma
Findings
Conclusions and Future Directions
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