[Targeting of membrane receptor tyrosine kinases: is there resistance in the HER?]

Bull Cancer. 2004 Sep;91(9):685-94.
[Article in French]

Abstract

Human Epidermal growth factor Receptors (HER) play an important role in cellular proliferation, and differentiation. Their overexpression in tumor tissues is often associated with a poor prognosis. Consequently, HER receptors are interesting therapeutic targets for cancer treatment. Two strategies are proposed. First, monoclonal antibodies can be used to inhibit the binding of one ligand to its receptor. The second approach is based upon the designing of tyrosine kinase inhibitors capable to bind into the phosphorylation site of the receptor. Consequently, both approaches block the signal transduction downstream. Resistance to anti receptor tyrosine kinase therapy can lead to enhanced morbidity associated with high therapeutic cost. Different mechanisms can be implicated. Non specific mechanisms include alterations of the signal transduction pathways (PI3K/AKT), recruitment of alternative receptor tyrosine kinase pathways (IGFR, VEGFR) and proteasome degradation inhibition. Other mechanisms are specific to HER and rely on inhibition of the binding of monoclonal antibodies (sialomucin-MUC4), heterodimerisation of HER, truncated soluble receptors intervention and mutated variants, as demonstrated very recently with EGF receptors, or genetic polymorphism. This paper reviews these different resistance mechanisms that have been identified in preclinical and clinical situations.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Drug Resistance, Neoplasm
  • Enzyme Inhibitors / therapeutic use*
  • ErbB Receptors / antagonists & inhibitors*
  • ErbB Receptors / genetics
  • ErbB Receptors / metabolism
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Mucin-4
  • Mucins / metabolism
  • Neoplasms / etiology
  • Neoplasms / metabolism
  • Neoplasms / therapy*
  • Proteasome Endopeptidase Complex / metabolism
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Receptor, ErbB-2 / metabolism
  • Receptor, ErbB-3 / antagonists & inhibitors
  • Receptor, ErbB-3 / metabolism
  • Receptor, ErbB-4
  • Receptor, IGF Type 1 / metabolism
  • Receptors, Vascular Endothelial Growth Factor / metabolism
  • Signal Transduction*
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Antibodies, Monoclonal
  • Enzyme Inhibitors
  • MUC4 protein, human
  • Mucin-4
  • Mucins
  • Vascular Endothelial Growth Factor A
  • Insulin-Like Growth Factor I
  • ERBB4 protein, human
  • ErbB Receptors
  • Protein-Tyrosine Kinases
  • Receptor, ErbB-2
  • Receptor, ErbB-3
  • Receptor, ErbB-4
  • Receptor, IGF Type 1
  • Receptors, Vascular Endothelial Growth Factor
  • Proteasome Endopeptidase Complex