Apoptosis-inducing anticancer drugs in clinical trials

Apoptosis, or programmed cell death, plays an essential role in controlling cell number in many developmental and physiologic settings as well as in chemotherapy-induced tumor cell killing. It is a genetically regulated biologic process that is regulated by the ratio of proapoptotic proteins over antiapoptotic proteins. Researchers have recently begun using apoptosis inducers in cancer therapy. In a number of studies, attempts have been made to induce apoptosis by triggering the tumor necrosis factor-related apoptosis-inducing ligand receptor and the Bcl-2 family of proteins, caspases, and inhibitors of apoptotic proteins. Most of these agents are still in the preclinical phase of development because of their low efficacy and potential for resistance. However, the results obtained with other agents have been promising. This chapter reviews the development of apoptosis inducing anticancer drugs in clinical trials.