Why Great Mitotic Inhibitors Make Poor Cancer Drugs

Victoria C. Yan, Hannah E. Butterfield, Anton H. Poral, Matthew J. Yan, Kristine L. Yang, Cong Dat Pham, Florian L. Muller

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations

Abstract

Chemotherapy is central to oncology, perceived to operate only on prolific cancerous tissue. Yet, many non-neoplastic tissues are more prolific compared with typical tumors. Chemotherapies achieve sufficient therapeutic windows to exert antineoplastic activity because they are prodrugs that are bioactivated in cancer-specific environments. The advent of precision medicine has obscured this concept, favoring the development of high-potency kinase inhibitors. Inhibitors of essential mitotic kinases exemplify this paradigm shift, but intolerable on-target toxicities in more prolific normal tissues have led to repeated failures in the clinic. Proliferation rates alone cannot be used to achieve cancer specificity. Here, we discuss integrating the cancer specificity of prodrugs from classical chemotherapeutics and the potency of mitotic kinase inhibitors to generate a class of high-precision cancer therapeutics.

Original languageEnglish (US)
Pages (from-to)924-941
Number of pages18
JournalTrends in Cancer
Volume6
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • cell cycle
  • chemotherapy
  • cyclin-dependent kinases
  • kinesin
  • precision oncology
  • pro-drug
  • targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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