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Unravelling mechanisms of cisplatin sensitivity and resistance in testicular cancer.

Abstract
Testicular cancer is the most frequent solid malignant tumour type in men 20-40 years of age. At the time of diagnosis up to 50% of the patients suffer from metastatic disease. In contrast to most other metastatic solid tumours, the majority of metastatic testicular cancer patients can be cured with highly effective cisplatin-based chemotherapy. This review aims to summarise the current knowledge on response to chemotherapy and the biological basis of cisplatin-induced apoptosis in testicular cancer. The frequent presence of wild-type TP53 and the low levels of p53 in complex with the p53 negative feed-back regulator MDM2 contribute to cisplatin sensitivity. Moreover, the high levels of the pluripotency regulator Oct4 and as a consequence of Oct4 expression high levels of miR-17/106b seed family and pro-apoptotic Noxa and the low levels of cytoplasmic p21 (WAF1/Cip1) appear to be causative for the exquisite sensitivity to cisplatin-based therapy of testicular cancer. However, resistance of testicular cancer to cisplatin-based therapy does occur and can be mediated through aberrant levels of the above mentioned key players. Drugs targeting these key players showed, at least pre-clinically, a sensitising effect to cisplatin treatment. Further clinical development of such treatment strategies will lead to new treatment options for platinum-resistant testicular cancers.
AuthorsR Koster, M A T M van Vugt, H Timmer-Bosscha, J A Gietema, S de Jong
JournalExpert reviews in molecular medicine (Expert Rev Mol Med) Vol. 15 Pg. e12 (Sep 30 2013) ISSN: 1462-3994 [Electronic] England
PMID24074238 (Publication Type: Journal Article, Review)
Chemical References
  • Antineoplastic Agents
  • Neoplasm Proteins
  • Cisplatin
Topics
  • Animals
  • Antineoplastic Agents (pharmacology, therapeutic use)
  • Cisplatin (pharmacology, therapeutic use)
  • Drug Resistance, Neoplasm
  • Genes, p53 (drug effects)
  • Humans
  • Male
  • Neoplasm Proteins (drug effects, genetics, metabolism)
  • Testicular Neoplasms (drug therapy, metabolism)

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