Abstract
Simple SummaryTackling the current dilemmas of cancer care, namely, financial and systemic burdens, is challenging. One way to address this challenge is to apply drug repurposing. Drug repurposing uses existing drugs for new medical indications like oncology. In drug repurposing, all clinical data is already in place, enabling fast translation into clinical applications. This review delineates the role of p53 and p73 as critical tumor suppressors and provides a comprehensive overview of drug repurposing avenues to reinstate the function of p53 proteins for cancer therapy.p53 and p73 are critical tumor suppressors that are often inactivated in human cancers through various mechanisms. Owing to their high structural homology, the proteins have many joined functions and recognize the same set of genes involved in apoptosis and cell cycle regulation. p53 is known as the ‘guardian of the genome’ and together with p73 forms a barrier against cancer development and progression. The TP53 is mutated in more than 50% of all human cancers and the germline mutations in TP53 predispose to the early onset of multiple tumors in Li–Fraumeni syndrome (LFS), the inherited cancer predisposition. In cancers where TP53 gene is intact, p53 is degraded. Despite the ongoing efforts, the treatment of cancers remains challenging. This is due to late diagnoses, the toxicity of the current standard of care and marginal benefit of newly approved therapies. Presently, the endeavors focus on reactivating p53 exclusively, neglecting the potential of the restoration of p73 protein for cancer eradication. Taken that several small molecules reactivating p53 failed in clinical trials, there is a need to develop new treatments targeting p53 proteins in cancer. This review outlines the most advanced strategies to reactivate p53 and p73 and describes drug repurposing approaches for the efficient reinstatement of the p53 proteins for cancer therapy.
Highlights
IntroductionIt is the media hype and the unreasonable costs of the majority of new cancer treatments, often delivering only a marginal benefit, which harm cancer patients
It is the media hype and the unreasonable costs of the majority of new cancer treatments, often delivering only a marginal benefit, which harm cancer patients.More often than not, new treatments fail to deliver advancement in the outcomes, including overall survival.Surrogate endpoints applied in clinical trials usually include disease-free survival (DFS)(or progression-free survival), or overall response rates (ORR) as the primary outcome instead of a patient-centered, overall survival (OS)
This review describes structures and tumor suppressor functions of p53 and p73, selected approaches to reactivate p53 proteins’ function in tumors and highlights the potential of drug repurposing approach for restoration of p53 and p73 for cancer therapy
Summary
It is the media hype and the unreasonable costs of the majority of new cancer treatments, often delivering only a marginal benefit, which harm cancer patients. Hard drug repurposing conveys the application of the drug from the non-oncology application, to improve the outcome of cancer therapy, often at a much lower cost than that of bringing a new treatment to the market [2]. This approach is economical as it takes advantage of the clinical information that is already available for the given drug, such as pharmacokinetic and pharmacodynamic profiles, maximum tolerated dose or clinical safety profile, which allows for shorter times for the treatment’s implementation into practice [3]. This review describes structures and tumor suppressor functions of p53 and p73, selected approaches to reactivate p53 proteins’ function in tumors and highlights the potential of drug repurposing approach for restoration of p53 and p73 for cancer therapy
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