p53-Based cyclotherapy: exploiting the 'guardian of the genome' to protect normal cells from cytotoxic therapy.
Side effects of chemotherapy are a major impediment in the treatment of cancer. Cyclotherapy is an emerging therapeutic strategy for protecting normal cells from the side effects of chemotherapy. Low, non-genotoxic doses of known p53 activators can be used to induce p53-dependent cell cycle arrest in normal cells bearing wild-type p53. This cytostatic effect of p53 can protect normal cells from the toxicity of S- or M-phase poisons. Here, we have reviewed existing cyclotherapy regimens using two well-known p53 activators, nutlin-3 and actinomycin D. We have highlighted an exemplar clinical perspective for cyclotherapy in breast cancer. The recent development of novel stapled peptides as activators of p53 without the corresponding cytotoxicity holds great promise for cyclotherapy to enhance the therapeutic window of existing chemotherapy drugs.
Dundee Cancer Centre, University of Dundee; Ninewells Hospital and Medical School, Dundee, UK.
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Rao
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Lain
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Thompson
D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D017209:Apoptosis / Q000235:genetics / Q000502:physiology; D001943:Breast Neoplasms / Q000188:drug therapy; D048708:Cell Growth Processes / Q000235:genetics / Q000502:physiology; D045744:Cell Line, Tumor; D003609:Dactinomycin / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D016678:Genome / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D010766:Phosphorylation; D010879:Piperazines / Q000494:pharmacology* / Q000627:therapeutic use; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
D007093:Imidazoles; D010879:Piperazines; D016159:Tumor Suppressor Protein p53; D003609:Dactinomycin; C482205:nutlin 3