The pleiotropic role of the KEAP1/NRF2 pathway in cancer

WL Wu, T Papagiannakopoulos - Annual review of cancer …, 2020 - annualreviews.org
Annual review of cancer biology, 2020annualreviews.org
The unregulated proliferative capacity of many tumors is dependent on dysfunctional
nutrient utilization and ROS (reactive oxygen species) signaling to sustain a deranged
metabolic state. Although it is clear that cancers broadly rely on these survival and signaling
pathways, how they achieve these aims varies dramatically. Mutations in the KEAP1/NRF2
pathway represent a potent cancer adaptation to exploit native cytoprotective pathways that
involve both nutrient metabolism and ROS regulation. Despite activating these …
The unregulated proliferative capacity of many tumors is dependent on dysfunctional nutrient utilization and ROS (reactive oxygen species) signaling to sustain a deranged metabolic state. Although it is clear that cancers broadly rely on these survival and signaling pathways, how they achieve these aims varies dramatically. Mutations in the KEAP1/NRF2 pathway represent a potent cancer adaptation to exploit native cytoprotective pathways that involve both nutrient metabolism and ROS regulation. Despite activating these advantageous processes, mutations within KEAP1/NRF2 are not universally selected for across cancers and instead appear to interact with particular tumor driver mutations and tissues of origin. Here, we highlight the relationship between the KEAP1/NRF2 signaling axis and tumor biology with a focus on genetic mutation, metabolism, immune regulation, and treatment implications and opportunities. Understanding the dysregulation of KEAP1 and NRF2 provides not only insight into a commonly mutated tumor suppressor pathway but also a window into the factors dictating the development and evolution of many cancers.
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