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Caspase Regulation in Non–Small Cell Lung Cancer and its Potential for Therapeutic Exploitation

Thoracic Oncology Research Group, Centre for Cancer Research and Cell Biology, Oncology, Belfast City Hospital, Belfast, Northern Ireland

Requests for reprints: Dean A. Fennell, Northern Ireland Thoracic Oncology Research Group, Centre for Cancer Research and Cell Biology, Oncology, University Floor, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB. Phone: 020890-329-241, ext. 3484; Fax: 028-90-263744; E-mail: d.fennell{at}qub.ac.uk.

Metastatic non–small cell lung cancer (NSCLC, stages IIIB/IV) is one of the most common and rapidly lethal causes of cancer related mortality worldwide. Efficacy of chemotherapy, the mainstay of treatment, is limited due to resistance in the vast majority of patients. NSCLC cells exhibit intrinsic apoptosis resistance. Understanding the molecular basis of this phenotype is critical, if therapy is to move beyond the therapeutic plateau that has been reached with conventional chemotherapy. Caspases occupy a pivotal position in the final common pathway of apoptosis. Increasing evidence suggests that these proteases are constitutively inhibited in NSCLC. This review discusses current knowledge relating to caspase regulation in NSCLC and highlights novel strategies for reversing the apoptosis resistant phenotype, with potential to accelerate development of effective therapy.

Key Words: Non–small cell lung cancer • Resistance • Apoptosis • Caspases • IAP proteins • DIABLO/Smac

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