Signaling pathways associated with tumorigenesis and combined treatments that alleviate drug resistance

Signaling pathways associated with tumorigenesis and combined treatments that alleviate drug resistance. Pharmaceutical CDK4/6 inhibitors palbociclib, ribociclib, and abemaciclib directly inhibit CDK4/6 activity. Moreover, the upstream mitogenic forces, including the canonical RAS-RAF-MEK-ERK pathway, heightened activity of the HER2-PI3K-AKT-mTOR axis, increase the cyclin D1 levels, activating CDK4/6 and promoting cellular progression to the S phase. Because of this foundation, PI3K, mTOR and MEK inhibitors induce synergistic anti-proliferative and pro-apoptotic effects, which lead to more durable cell cycle arrest and a delay to the onset of resistance. The Aromatase Inhibitors (AI), which inhibit the transformation of androgen into estradiol, thereby suppress breast cancer cell growth. Selective estrogen receptor modulator (SERM) and selective estrogen receptor downregulator (SERD) can affect estrogen receptors to produce the same inhibitory effect on tumor cells. ALT can keep p27 in a non-phosphorylated state, which is a stable form, and reduce both CDK2 and CDK4 activity. BMP4 and Fangchinoline can upregulate p21. Fangchinoline not only increases the level of CKIs (p21 and p27), but also inhibits cyclin D1/D3/E and CDK2/4/6. The ALT, BMP4 and Fangchinoline are still under preclinical study. In addition, clinical studies on the combination of CDK4/6 inhibitors with anti-HER2 therapy and immunotherapy are under way.
Signaling pathways associated with tumorigenesis and combined treatments that alleviate drug resistance

Publication

Cyclin-Dependent Kinases 4/6 Inhibitors in Breast Cancer: Current Status, Resistance, and Combination Strategies. (2019) Ying Niu, et al. J Cancer. 2019;10(22):5504-5517. Figure: F2.

Gene mentions


Organism Group Word Match Source NCBI Symbol NCBI ID
Homo sapiens Primates HER2 HER2 ncbigene_synonym ERBB2 2064
Homo sapiens Primates EGFR EGFR ncbigene_symbol EGFR 1956
Homo sapiens Primates IGFR IGFR ncbigene_synonym IGF1R 3480
Homo sapiens Primates IRS-1 IRS1 ncbigene_symbol IRS1 3667
Homo sapiens Primates PI3K PI3K ncbigene_synonym PIK3CA 5290
Homo sapiens Primates PI3K PI3K ncbigene_synonym PIK3CB 5291
Homo sapiens Primates PI3K PI3K ncbigene_synonym PIK3CD 5293
Homo sapiens Primates PI3K PI3K ncbigene_synonym PIK3CG 5294
Homo sapiens Primates PI3K PI3K famplex_relations PIK3R3 8503
Homo sapiens Primates PI3K PI3K famplex_relations PIK3R4 30849
Homo sapiens Primates PI3K PI3K famplex_relations PIK3R5 23533
Homo sapiens Primates PI3K PI3K famplex_relations PIK3R6 146850
Homo sapiens Primates PI3K PI3K famplex_relations PIK3R1 5295
Homo sapiens Primates PI3K PI3K famplex_relations PIK3R2 5296
Homo sapiens Primates RAS RAS famplex_relations KRAS 3845
Homo sapiens Primates RAS RAS famplex_relations HRAS 3265
Homo sapiens Primates RAS RAS famplex_relations NRAS 4893
Homo sapiens Primates AKT AKT ncbigene_synonym AKT1 207
Homo sapiens Primates AKT AKT famplex_relations AKT2 208
Homo sapiens Primates AKT AKT famplex_relations AKT3 10000
Homo sapiens Primates RAF RAF ncbigene_synonym ZHX2 22882
Homo sapiens Primates RAF RAF famplex_relations ARAF 369
Homo sapiens Primates RAF RAF famplex_relations BRAF 673
Homo sapiens Primates RAF RAF famplex_relations RAF1 5894
Homo sapiens Primates MTOR MTOR ncbigene_symbol MTOR 2475
Homo sapiens Primates MEKİ MEK ncbigene_synonym MAP2K7 5609
Homo sapiens Primates MEKİ MEK famplex_relations MAP2K1 5604
Homo sapiens Primates MEKİ MEK famplex_relations MAP2K2 5605
Homo sapiens Primates ERK ERK ncbigene_synonym EPHB2 2048
Homo sapiens Primates ERK ERK ncbigene_synonym MAPK1 5594
Homo sapiens Primates ERK ERK famplex_relations MAPK3 5595
Homo sapiens Primates CyclinD1 CCND1 ncbigene_symbol CCND1 595
Homo sapiens Primates CDK4/6Inhibitors: CDK4 ncbigene_symbol CDK4 1019
Homo sapiens Primates CDK4/6 CDK6 ncbigene_symbol CDK6 1021
Homo sapiens Primates p21 P21 ncbigene_synonym CDKN1A 1026
Homo sapiens Primates p21 P21 ncbigene_synonym TCEAL1 9338
Homo sapiens Primates p21 P21 ncbigene_synonym NSG1 27065
Homo sapiens Primates p21 P21 ncbigene_synonym H3P16 644914
Homo sapiens Primates BMP4 BMP4 ncbigene_symbol BMP4 652
Homo sapiens Primates CyclinE CYCLINE famplex_relations CCNE1 898
Homo sapiens Primates CyclinE CYCLINE famplex_relations CCNE2 9134
Homo sapiens Primates CDK2 CDK2 ncbigene_symbol CDK2 1017
Homo sapiens Primates ALT ALT ncbigene_synonym GPT 2875
Homo sapiens Primates p27 P27 ncbigene_synonym IFI27 3429
Homo sapiens Primates p27 P27 ncbigene_synonym PSMD9 5715
Homo sapiens Primates p27 P27 ncbigene_synonym ZNRD2 10534
Homo sapiens Primates p27 P27 ncbigene_synonym DCTN6 10671
Homo sapiens Primates p27 P27 ncbigene_synonym TMED7 51014
Homo sapiens Primates p27 P27 ncbigene_synonym H3P23 115482696
Drosophila melanogaster Invertebrates EGFR EGFR ncbigene_symbol Egfr 37455
Drosophila melanogaster Invertebrates PI3K PI3K ncbigene_synonym Pi3K21B 33203
Drosophila melanogaster Invertebrates PI3K PI3K ncbigene_synonym Pi3K59F 37733
Drosophila melanogaster Invertebrates PI3K PI3K ncbigene_synonym Pi3K68D 39329
Drosophila melanogaster Invertebrates PI3K PI3K ncbigene_synonym Pi3K92E 42446
Drosophila melanogaster Invertebrates RAS RAS ncbigene_symbol ras 43873
Drosophila melanogaster Invertebrates RAS RAS ncbigene_synonym Ras64B 38494
Drosophila melanogaster Invertebrates RAS RAS ncbigene_synonym Ras85D 41140
Drosophila melanogaster Invertebrates AKT AKT ncbigene_symbol Akt 41957
Drosophila melanogaster Invertebrates RAF RAF ncbigene_symbol Raf 31221
Drosophila melanogaster Invertebrates MTOR MTOR ncbigene_symbol Mtor 36264
Drosophila melanogaster Invertebrates MTOR MTOR ncbigene_synonym Tor 47396
Drosophila melanogaster Invertebrates MEKİ MEK ncbigene_synonym Dsor1 31872
Drosophila melanogaster Invertebrates MEKİ MEK ncbigene_synonym Mtk 36708
Drosophila melanogaster Invertebrates ERK ERK ncbigene_synonym Erk7 31877
Drosophila melanogaster Invertebrates ERK ERK ncbigene_synonym rl 3354888
Drosophila melanogaster Invertebrates CDK4/6Inhibitors: CDK4 ncbigene_symbol Cdk4 36854
Drosophila melanogaster Invertebrates p21 P21 ncbigene_synonym dap 36001
Drosophila melanogaster Invertebrates CyclinE CYCLINE ncbigene_synonym CycE 34924
Drosophila melanogaster Invertebrates CDK2 CDK2 ncbigene_symbol Cdk2 42453
Drosophila melanogaster Invertebrates ALT ALT ncbigene_symbol alt 42127
Drosophila melanogaster Invertebrates ALT ALT ncbigene_synonym CG1640 32292
Drosophila melanogaster Invertebrates p27 P27 ncbigene_synonym DCTN6-p27 35195
Drosophila melanogaster Invertebrates p27 P27 ncbigene_synonym CG9588 41672
Danio rerio Vertebrates HER2 HER2 ncbigene_symbol her2 30300
Danio rerio Vertebrates EGFR EGFR ncbigene_synonym egfra 378478
Danio rerio Vertebrates IRS-1 IRS1 ncbigene_symbol irs1 559281
Danio rerio Vertebrates RAS RAS ncbigene_synonym rab1ab 368883
Danio rerio Vertebrates MTOR MTOR ncbigene_symbol mtor 324254
Danio rerio Vertebrates CyclinD1 CCND1 ncbigene_symbol ccnd1 30222
Danio rerio Vertebrates CDK4/6Inhibitors: CDK4 ncbigene_symbol cdk4 777730
Danio rerio Vertebrates CDK4/6 CDK6 ncbigene_symbol cdk6 100034507
Danio rerio Vertebrates p21 P21 ncbigene_synonym cdkn1a 100151416
Danio rerio Vertebrates BMP4 BMP4 ncbigene_symbol bmp4 30612
Danio rerio Vertebrates CDK2 CDK2 ncbigene_symbol cdk2 406715

Chemical mentions

Word Match MeSH Name ChEBI
Androgen Androgens mesh:D000728 androgen chebi:50113
Al NA mesh:D000535
lapatinib NA mesh:C490728
neratinib neratinib mesh:C487932 neratinib chebi:61397
letrozole NA mesh:C067431
anastrozole NA mesh:C090450
Estradiol Estradiol mesh:D004958 17beta-estradiol chebi:16469
exemestane exemestane mesh:C056516 exemestane chebi:4953
everolimus NA mesh:C107135
tamoxifen Tamoxifen mesh:D013629 tamoxifen chebi:41774
toremifene Toremifene mesh:D017312 toremifene chebi:9635
fulvestrant NA mesh:C070081
Fangchinoline fangchinoline mesh:C060802 fangchinoline chebi:132893

Disease mentions

Word Match MeSH Name DOID
Cancer NA
Cardiomyopathy NA
Lung cancer NA
Noonan syndrome NA