Why do BCL-2 inhibitors work and where should we use them in the clinic?

Cell Death Differ. 2018 Jan;25(1):56-64. doi: 10.1038/cdd.2017.183. Epub 2017 Oct 27.

Abstract

Intrinsic apoptosis is controlled by the BCL-2 family of proteins but the complexity of intra-family interactions makes it challenging to predict cell fate via standard molecular biology techniques. We discuss BCL-2 family regulation and how to determine cells' readiness for apoptosis and anti-apoptotic dependence. Cancer cells often adopt anti-apoptotic defense mechanisms in response to oncogenic stress or anti-cancer therapy. However, by determining their anti-apoptotic addiction, we can use novel BH3 mimetics to overwhelm this apoptotic blockade. We outline the development and uses of these unique anti-apoptotic inhibitors and how to possibly combine them with other anti-cancer agents using dynamic BH3 profiling (DBP) to improve personalized cancer treatment.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Apoptosis Regulatory Proteins / physiology
  • Apoptosis*
  • Cell Membrane Permeability
  • Humans
  • Mitochondrial Membranes / metabolism
  • Neoplasms / drug therapy*
  • Proto-Oncogene Proteins c-bcl-2 / antagonists & inhibitors*
  • Proto-Oncogene Proteins c-bcl-2 / physiology

Substances

  • Antineoplastic Agents
  • Apoptosis Regulatory Proteins
  • BCL2 protein, human
  • Proto-Oncogene Proteins c-bcl-2