Hepatocellular carcinoma(HCC) is one of the leading causes of cancer-related death worldwide. It is associated with a poor prognosis and has limited treatment options. Sorafenib, a multi-targeted kinase inhibitor, is ...Hepatocellular carcinoma(HCC) is one of the leading causes of cancer-related death worldwide. It is associated with a poor prognosis and has limited treatment options. Sorafenib, a multi-targeted kinase inhibitor, is the only available systemic agent for treatment of HCC that improves overall survival for patients with advanced stage disease; unfortunately, an effective second-line agent for the treatment of progressive or sorafenib-resistant HCC has yet to be identified. This review focuses on components of the mammalian target of rapamycin(mTOR) pathway, its role in HCC pathogenesis, and dual mTOR inhibition as a therapeutic option with potential efficacy in advanced HCC. There are several important upstream and downstream signals in the mTOR pathway, and alternative tumor-promoting pathways are known to exist beyond mTORC1 inhibition in HCC. This review analyzes the relationships of the upstream and downstream regulators of mTORC1 and mTORC2 signaling; it also provides a comprehensive global picture of the interaction between mTORC1 and mTORC2 which demonstrates the pre-clinical relevance of the mTOR pathway in HCC pathogenesis and progression. Finally, it provides scientific rationale for dual mTORC1 and mTORC2 inhibition in the treatment of HCC. Clinical trials utilizing mTORC1 inhibitors and dual mTOR inhibitors in HCC are discussed as well. The mTOR pathway is comprised of two main components, mTORC1 and mTORC2; each has a unique role in the pathogenesis and progression of HCC. In phase Ⅲ studies, mTORC1 inhibitors demonstrate anti-tumor ac-tivity in advanced HCC, but dual mTOR(mTORC1 and mTORC2) inhibition has greater therapeutic potential in HCC treatment which warrants further clinical investigation.展开更多
哺乳动物西罗莫司靶蛋白(mammalian target of sirolimus,mTOR)参与细胞周期调控的多个步骤,是调节细胞生长的关键蛋白,在细胞中以两种复合物的形式存在,即mTORC1和mTORC2。mTOR被异常激活后会促使癌细胞的高速分化,而其活性被抑制后能...哺乳动物西罗莫司靶蛋白(mammalian target of sirolimus,mTOR)参与细胞周期调控的多个步骤,是调节细胞生长的关键蛋白,在细胞中以两种复合物的形式存在,即mTORC1和mTORC2。mTOR被异常激活后会促使癌细胞的高速分化,而其活性被抑制后能使细胞周期阻滞在G1期。近几年的研究证明,mTOR是抗癌、免疫抑制和抗衰老治疗的重要靶点。根据作用位点不同,以mTOR为靶点的抑制剂主要分为两类,即作用于FKBP12蛋白连接区的西罗莫司衍生物和作用于ATP连接区的小分子化合物。现已有多种用于抗癌或免疫抑制的西罗莫司衍生物类药物上市,而针对ATP竞争性mTOR抑制剂的研究也成为热点。展开更多
文摘Hepatocellular carcinoma(HCC) is one of the leading causes of cancer-related death worldwide. It is associated with a poor prognosis and has limited treatment options. Sorafenib, a multi-targeted kinase inhibitor, is the only available systemic agent for treatment of HCC that improves overall survival for patients with advanced stage disease; unfortunately, an effective second-line agent for the treatment of progressive or sorafenib-resistant HCC has yet to be identified. This review focuses on components of the mammalian target of rapamycin(mTOR) pathway, its role in HCC pathogenesis, and dual mTOR inhibition as a therapeutic option with potential efficacy in advanced HCC. There are several important upstream and downstream signals in the mTOR pathway, and alternative tumor-promoting pathways are known to exist beyond mTORC1 inhibition in HCC. This review analyzes the relationships of the upstream and downstream regulators of mTORC1 and mTORC2 signaling; it also provides a comprehensive global picture of the interaction between mTORC1 and mTORC2 which demonstrates the pre-clinical relevance of the mTOR pathway in HCC pathogenesis and progression. Finally, it provides scientific rationale for dual mTORC1 and mTORC2 inhibition in the treatment of HCC. Clinical trials utilizing mTORC1 inhibitors and dual mTOR inhibitors in HCC are discussed as well. The mTOR pathway is comprised of two main components, mTORC1 and mTORC2; each has a unique role in the pathogenesis and progression of HCC. In phase Ⅲ studies, mTORC1 inhibitors demonstrate anti-tumor ac-tivity in advanced HCC, but dual mTOR(mTORC1 and mTORC2) inhibition has greater therapeutic potential in HCC treatment which warrants further clinical investigation.
文摘哺乳动物西罗莫司靶蛋白(mammalian target of sirolimus,mTOR)参与细胞周期调控的多个步骤,是调节细胞生长的关键蛋白,在细胞中以两种复合物的形式存在,即mTORC1和mTORC2。mTOR被异常激活后会促使癌细胞的高速分化,而其活性被抑制后能使细胞周期阻滞在G1期。近几年的研究证明,mTOR是抗癌、免疫抑制和抗衰老治疗的重要靶点。根据作用位点不同,以mTOR为靶点的抑制剂主要分为两类,即作用于FKBP12蛋白连接区的西罗莫司衍生物和作用于ATP连接区的小分子化合物。现已有多种用于抗癌或免疫抑制的西罗莫司衍生物类药物上市,而针对ATP竞争性mTOR抑制剂的研究也成为热点。
