Vlasiou Manos C
University of Nicosia School of Veterinary Medicine, Cyprus.
Anticancer Agents Med Chem. 2025 Jul 21. doi: 10.2174/0118715206387712250711132221.
Cancer progression is increasingly understood to be influenced by neural mechanisms, including neurotransmitter signaling, neurotrophic factor activity, neuroinflammation, and neurogenic inflammation. These neurobiological interactions contribute to tumor proliferation, angiogenesis, and metastasis. Kinase inhibitors, a class of targeted therapies that block dysregulated kinase activity, have demonstrated promise not only in direct tumor suppression but also in modulating neural pathways associated with cancer progression.
This review examines the role of kinase inhibitors in modulating cancer-associated neural mechanisms. A comprehensive literature search was conducted to identify studies exploring the effects of kinase inhibition on: (1) neurotransmitter signaling pathways; (2) neurotrophic factors such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF); (3) neuroinflammation through glial cell modulation; and (4) neurogenic inflammation. Additionally, we assessed the impact of kinase inhibitors on tumor-induced axonogenesis and stress-related signaling. Clinical relevance was evaluated through analysis of preclinical models, human case studies, and outcomes from relevant clinical trials.
Kinase inhibitors were found to significantly modulate neural factors that facilitate tumor growth. Specifically, they can suppress neurotrophic signaling (e.g., NGF/TrkA, BDNF/TrkB), inhibit glial activation, reduce pro-inflammatory cytokine production, and block neurotransmitter-induced proliferation. Inhibition of stress-responsive kinases such as p38 MAPK and JNK also disrupted tumor-associated axonogenesis and inflammation. Clinical trials demonstrate improved outcomes in cancers such as glioblastoma, breast cancer, and pancreatic cancer when kinase inhibitors are employed with consideration of neural mechanisms.
These findings support the emerging concept of targeting the neural tumor microenvironment as a therapeutic strategy. Kinase inhibitors represent a dual-action approach, suppressing both cancer cell intrinsic growth pathways and the neural factors that sustain them. However, several challenges persist, including resistance mechanisms, variability in patient neural profiles, and off-target effects. Future research should focus on the development of neural-specific kinase inhibitors, the use of neural biomarkers for therapy selection, and the integration of neuro-oncology into personalized treatment plans.
Kinase inhibitors offer a promising frontier in cancer treatment by targeting neural mechanisms that contribute to tumor progression. While current evidence is encouraging, further investigation is required to optimize their use within neuro-oncology. Personalized approaches and novel targets within the neural-cancer axis will be essential for translating this strategy into clinical practice and improving long-term patient outcomes.
人们越来越认识到癌症进展受神经机制影响,包括神经递质信号传导、神经营养因子活性、神经炎症和神经源性炎症。这些神经生物学相互作用促进肿瘤增殖、血管生成和转移。激酶抑制剂是一类阻断失调激酶活性的靶向疗法,不仅在直接抑制肿瘤方面显示出前景,而且在调节与癌症进展相关的神经通路方面也有成效。
本综述探讨激酶抑制剂在调节癌症相关神经机制中的作用。进行了全面的文献检索,以确定探索激酶抑制作用的研究,这些研究涉及:(1)神经递质信号通路;(2)神经营养因子,如神经生长因子(NGF)和脑源性神经营养因子(BDNF);(3)通过胶质细胞调节的神经炎症;(4)神经源性炎症。此外,我们评估了激酶抑制剂对肿瘤诱导的轴突发生和应激相关信号传导的影响。通过分析临床前模型、人类病例研究和相关临床试验结果来评估临床相关性。
发现激酶抑制剂可显著调节促进肿瘤生长的神经因子。具体而言,它们可抑制神经营养信号传导(如NGF/TrkA、BDNF/TrkB),抑制胶质细胞活化,减少促炎细胞因子产生,并阻断神经递质诱导的增殖。抑制应激反应激酶如p38丝裂原活化蛋白激酶(MAPK)和c-Jun氨基末端激酶(JNK)也会破坏肿瘤相关的轴突发生和炎症。临床试验表明,在考虑神经机制的情况下使用激酶抑制剂时,胶质母细胞瘤、乳腺癌和胰腺癌等癌症的治疗效果有所改善。
这些发现支持将靶向神经肿瘤微环境作为一种治疗策略这一新兴概念。激酶抑制剂代表一种双重作用方法,既抑制癌细胞内在生长途径,又抑制维持这些途径的神经因子。然而,仍存在一些挑战,包括耐药机制、患者神经特征的变异性和脱靶效应。未来的研究应侧重于开发神经特异性激酶抑制剂、使用神经生物标志物进行治疗选择,以及将神经肿瘤学纳入个性化治疗方案。
激酶抑制剂通过靶向促成肿瘤进展的神经机制,为癌症治疗提供了一个有前景的领域。虽然目前的证据令人鼓舞,但仍需要进一步研究以优化其在神经肿瘤学中的应用。神经-癌症轴内的个性化方法和新靶点对于将这一策略转化为临床实践并改善患者长期预后至关重要。