title: Targeting the Bcl-2 family for cancer therapy.
abstract: BACKGROUND
  Programmed cell death is well-orchestrated process regulated by multiple pro-apoptotic and anti-apoptotic genes, particularly those of the Bcl-2 gene family. These genes are well documented in cancer with aberrant expression being strongly associated with resistance to chemotherapy and radiation.
  
  
  METHODS
  This review focuses on the resistance induced by the Bcl-2 family of anti-apoptotic proteins and current therapeutic interventions currently in preclinical or clinical trials that target this pathway. Major resistance mechanisms that are regulated by Bcl-2 family proteins and potential strategies to circumvent resistance are also examined. Although antisense and gene therapy strategies are used to nullify Bcl-2 family proteins, recent approaches use small molecule inhibitors (SMIs) and peptides. Structural similarity of the Bcl-2 family of proteins greatly favors development of inhibitors that target the BH3 domain, called BH3 mimetics.
  
  
  CONCLUSIONS
  Strategies to specifically identify and inhibit critical determinants that promote therapy resistance and tumor progression represent viable approaches for developing effective cancer therapies. From a clinical perspective, pretreatment with novel, potent Bcl-2 inhibitors either alone or in combination with conventional therapies hold significant promise for providing beneficial clinical outcomes. Identifying SMIs with broader and higher affinities for inhibiting all of the Bcl-2 pro-survival proteins will facilitate development of superior cancer therapies.
authors.affiliation: Virginia Commonwealth University, Department of Human and Molecular Genetics, Richmond, VA 23298, USA.
authors.forename: Shibu
authors.initials: S
authors.lastname: Thomas
authors.forename: Bridget A
authors.initials: BA
authors.lastname: Quinn
authors.forename: Swadesh K
authors.initials: SK
authors.lastname: Das
authors.forename: Rupesh
authors.initials: R
authors.lastname: Dash
authors.forename: Luni
authors.initials: L
authors.lastname: Emdad
authors.forename: Santanu
authors.initials: S
authors.lastname: Dasgupta
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Dent
authors.forename: John C
authors.initials: JC
authors.lastname: Reed
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pellecchia
authors.forename: Devanand
authors.initials: D
authors.lastname: Sarkar
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fisher
mesh_terms: D000818:Animals; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm / Q000502:physiology; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism*
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2