Resistance to therapy and disease progression are the main causes of mortality in most cancers. In particular, the development of resistance is an important limitation affecting the efficacy of therapeutic alternatives for cancer, including chemotherapy, radiotherapy, and immunotherapy. Signaling pathways are largely responsible for the mechanisms of resistance to cancer treatment and progression, and multiple myeloma is no exception. p38 mitogen-activated protein kinase (p38) is downstream of several signaling pathways specific to treatment resistance and progression. Therefore, in recent years, developing therapeutic alternatives directed at p38 has been of great interest, in order to reverse chemotherapy resistance and prevent progression. In this review, we discuss recent findings on the role of p38, including recent advances in our understanding of its expression and activity as well as its isoforms, and its possible clinical role based on the mechanisms of resistance and progression in multiple myeloma.
在大多数癌症中,治疗抵抗与疾病进展是导致患者死亡的主要原因。特别是耐药性的产生,已成为制约化疗、放疗及免疫疗法等癌症治疗手段疗效的重要瓶颈。信号通路在很大程度上决定了癌症治疗抵抗与疾病进展的机制,多发性骨髓瘤亦不例外。p38丝裂原活化蛋白激酶(p38)位于多个与治疗抵抗及疾病进展相关的特异性信号通路下游。因此,近年来针对p38开发治疗策略以逆转化疗耐药并阻止疾病进展,已成为研究热点。本综述将探讨p38作用机制的最新研究进展,包括对其表达调控、活性调节及亚型功能认知的新突破,并基于多发性骨髓瘤耐药与进展机制,阐述其潜在的临床应用价值。
p38 Molecular Targeting for Next-Generation Multiple Myeloma Therapy