Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward

Targeting the cell cycle has become a focus of cancer research bearing impressive results with the introduction of CDK4/6 inhibitors in the treatment of ER-positive/HER2-negative breast cancers. However, no definitive benefit in other cancers has been observed. In gastrointestinal cancers, despite p...

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Main Author: Ioannis A. Voutsadakis
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Current Issues in Molecular Biology
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Online Access:https://www.mdpi.com/1467-3045/47/6/454
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author Ioannis A. Voutsadakis
author_facet Ioannis A. Voutsadakis
author_sort Ioannis A. Voutsadakis
collection DOAJ
description Targeting the cell cycle has become a focus of cancer research bearing impressive results with the introduction of CDK4/6 inhibitors in the treatment of ER-positive/HER2-negative breast cancers. However, no definitive benefit in other cancers has been observed. In gastrointestinal cancers, despite preclinical studies pinpointing positive effects on cancer inhibition in pre-clinical models, no positive clinical trials have been published with CDK4/6 inhibitors. Several biomarkers have been proposed in breast cancers, where the field is more advanced, and include up-regulations of the inhibited kinases CDK4 and CDK6 and their partner cyclin D as well as the main target of phosphorylation, RB. Up-regulation of Cyclin E, an E2F1/RB regulated gene, also arises as a marker of CDK4/6 inhibition resistance. Signaling from receptor tyrosine kinase pathways through KRAS/BRAF/MEK and PI3K/AKT/mTOR are also implicated in feedback CDK4/6 activation and inhibitors resistance. In gastrointestinal cancers, some of these biomarkers have also proven valuable in predicting sensitivity to CDK4/6 inhibitors and would lead markers to guide clinical development. Modulation of the tumor microenvironment, where immune cells are prominent components, arises as a feature of CDK4/6 inhibition and could be harnessed in therapeutic combinations.
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spelling doaj-art-0f49095bfb3f49c686d659f823e9c3232025-08-20T02:24:37ZengMDPI AGCurrent Issues in Molecular Biology1467-30371467-30452025-06-0147645410.3390/cimb47060454Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move ForwardIoannis A. Voutsadakis0Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USATargeting the cell cycle has become a focus of cancer research bearing impressive results with the introduction of CDK4/6 inhibitors in the treatment of ER-positive/HER2-negative breast cancers. However, no definitive benefit in other cancers has been observed. In gastrointestinal cancers, despite preclinical studies pinpointing positive effects on cancer inhibition in pre-clinical models, no positive clinical trials have been published with CDK4/6 inhibitors. Several biomarkers have been proposed in breast cancers, where the field is more advanced, and include up-regulations of the inhibited kinases CDK4 and CDK6 and their partner cyclin D as well as the main target of phosphorylation, RB. Up-regulation of Cyclin E, an E2F1/RB regulated gene, also arises as a marker of CDK4/6 inhibition resistance. Signaling from receptor tyrosine kinase pathways through KRAS/BRAF/MEK and PI3K/AKT/mTOR are also implicated in feedback CDK4/6 activation and inhibitors resistance. In gastrointestinal cancers, some of these biomarkers have also proven valuable in predicting sensitivity to CDK4/6 inhibitors and would lead markers to guide clinical development. Modulation of the tumor microenvironment, where immune cells are prominent components, arises as a feature of CDK4/6 inhibition and could be harnessed in therapeutic combinations.https://www.mdpi.com/1467-3045/47/6/454CDK4CDK6RBE2F1abemaciclibpalbociclib
spellingShingle Ioannis A. Voutsadakis
Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward
Current Issues in Molecular Biology
CDK4
CDK6
RB
E2F1
abemaciclib
palbociclib
title Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward
title_full Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward
title_fullStr Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward
title_full_unstemmed Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward
title_short Development of CDK4/6 Inhibitors in Gastrointestinal Cancers: Biomarkers to Move Forward
title_sort development of cdk4 6 inhibitors in gastrointestinal cancers biomarkers to move forward
topic CDK4
CDK6
RB
E2F1
abemaciclib
palbociclib
url https://www.mdpi.com/1467-3045/47/6/454
work_keys_str_mv AT ioannisavoutsadakis developmentofcdk46inhibitorsingastrointestinalcancersbiomarkerstomoveforward