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CANCER DRUGS: TARGETING UNDRUGGABLE PROTEINS

Many of us know someone who has been affected by cancer. At first glance, current cancer statistics look grim: the average American has about a 40% lifetime risk of developing cancer and a 20% chance of dying from it.1 Yet there is reason to be optimistic. In the past decade, scientists have tremendously advanced our understanding of underlying causes of cancer, while also developing novel drugs that may potentially deliver safer and more robust cancer treatments than conventional FDA-approved small-molecule inhibitors. Many prominent scientists in the field of drug discovery, including Brent Stockwell, a chemical biologist at Columbia University in New York, believe that the challenge of coming up with new cancer treatments lies in undruggable disease-causing proteins.2,3 These mutated or aberrantly regulated proteins are considered extremely difficult to target with available drug discovery technologies.3 A poster child of undruggable proteins is mutated K-Ras, which is responsible for about one-third of all cancers.3 Ras protein family members (K-Ras, N-Ras, and H-Ras) have been studied for more than thirty years and are thought to play a crucial role in the regulation of cell proliferation, differentiation, and survival, by signaling through a number of downstream pathways.4 The signaling function of Ras proteins is tightly controlled by the cell through a mechanism that resembles a light switch. In healthy cells, Ras proteins cycle between a GDP-bound state—when the growth signal is off—and a GTP-bound state—when the growth signal is on.3 The transition between these two states is in part regulated by binding of GTPase-activating proteins (GAPs). These vigilant regulators convert GTP to GDP and make sure that the cell growth signaling function of Ras proteins gets turned off in a timely manner. Mutations in genes that code for the structure of Ras proteins can interfere with GAP binding. This causes Ras proteins to get stuck in a permanently activated “on” state, which ultimately leads to uncontrolled proliferation of Ras-mutant cells.4 Scientists are not yet sure what causes mutations in Ras genes, but the evidence that these mutations contribute to cancer is indisputable.3 CANCER DRUGS: TARGETING UNDRUGGABLE PROTEINS