Side-Stepping the Guardian of the Genome: Current Cancer Therapeutics
Targeting Mutant p53
Abstract
Cancer therapies have attempted to target the transcription factor p53,
a gene also described as the “guardian of the genome,” for decades.
However, the approach has faced numerous barriers to clinical efficacy
due to several factors: mutations in p53 occur in almost half of all
human cancers, mutations are cancer-specific, and the associated genomic
changes grant mutant p53 with oncogenic potential unique from that of
wild-type p53. A host of new therapeutic agents have emerged that work
to target mutant p53. These agents can broadly be classified into six
categories: the viral approach, direct modifiers of the p53 pathway,
epigenetic modifiers of the p53 pathway, synthetic lethal agents,
structural reactivators, and immune activating vaccines. Even these
strategies have been met with limited success. Bypassing p53 entirely
may be the next avenue in cancer therapeutics to kill tumor cells
regardless of p53’s mutation pattern.