Targeting the MDM2–p53 Protein–Protein Interaction for New Cancer Therapy: Progress and Challenges
Open accessAbstract
MDM2 is a primary cellular inhibitor of p53. It inhibits p53 function by multiple mechanisms, each of which, however, is mediated by their direct interaction. It has been proposed that small-molecule inhibitors designed to block the MDM2-p53 interaction may be effective in the treatment of human cancer retaining wild-type p53 by reactivating the p53 tumor suppressor function. Through nearly two decades of intense efforts, a number of structurally distinct, highly potent, nonpeptide, small-molecule inhibitors of the MDM2-p53 interaction (MDM2 inhibitors) have been successfully designed and developed, and at least seven such compounds have now been advanced into human clinical trials as new anticancer drugs. This review offers a perspective on the design and development of MDM2 small-molecule inhibitors and discusses early clinical data for some of the MDM2 small-molecule inhibitors and future challenges for the successful clinical development of MDM2 inhibitors for cancer treatment.
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Nine MDM2 inhibitors have entered clinical trials: RG7112, RG7388/RO6839921, MK-8242, AMG232, SAR405838, DS-3032b, HDM201, NVP-CGM097 and APG-115.
“According to these three clear binding sites, a variety of structural types of MDM2 inhibitors have been reported, among which nine have entered clinical trials (RG7112, RG7388/RO6839921, MK-8242, AMG232, SAR405838, DS-3032b, HDM201, NVP-CGM097 and APG-115) (Fig. 3), with a variety of scaffold types [15–18].”
From Targeting p53–MDM2 interaction by small-molecule inhibitors: learning from MDM2 inhibitors in clinical trials (2022) · cites this paper as [15]
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Cites
In Vivo Activation of the p53 Pathway by Small-Molecule Antagonists of MDM2
Vassilev, L. T., Vu, B. T., Graves, B., Carvajal, D., Podlaski, F., Filipovic, Z., Kong, N., Kammlott, U., Lukacs, C., Klein, C., et al. (2004) · Science · doi:10.1126/science.1092472 · Cited by 4,661 · see citing works
Live or let die: the cell's response to p53
Vousden, K. H., & Lü, X. (2002) · Nature reviews. Cancer · doi:10.1038/nrc864 · Cited by 3,177 · see citing works
Structure of the MDM2 Oncoprotein Bound to the p53 Tumor Suppressor Transactivation Domain
Kussie, P. H., Gorina, S., Marechal, V., Elenbaas, B., Moreau, J., Levine, A. J., & Pavletich, N. P. (1996) · Science · doi:10.1126/science.274.5289.948 · Cited by 2,206 · see citing works
Amplification of a gene encoding a p53-associated protein in human sarcomas
Oliner, J. D., Kinzler, K. W., Meltzer, P. S., George, D. L., & Vogelstein, B. (1992) · Nature · doi:10.1038/358080a0 · Cited by 1,949 · see citing works
The p53-mdm-2 autoregulatory feedback loop.
Wu, X., Bayle, J. H., Olson, D., & Levine, A. J. (1993) · Genes & Development · doi:10.1101/gad.7.7a.1126 · Cited by 1,801 · see citing works
Rescue of early embryonic lethality in mdm2-deficient mice by deletion of p53
de Oca Luna, R. M., Wagner, D. S., & Lozano, G. (1995) · Nature · doi:10.1038/378203a0 · Cited by 1,420 · see citing works
Regulating the p53 pathway: in vitro hypotheses, in vivo veritas
Toledo, F., & Wahl, G. M. (2006) · Nature reviews. Cancer · doi:10.1038/nrc2012 · Cited by 1,286 · see citing works
Rescue of embryonic lethality in Mdm2-deficient mice by absence of p53
Jones, S. N., Roe, A. E., Donehower, L. A., & Bradley, A. (1995) · Nature · doi:10.1038/378206a0 · Cited by 1,280 · cited 1× · see citing works
“The role of MDM2 as a primary negative endogenous regulator of p53 is unambiguously established by the fact that MDM2-null is embryonically lethal in mice, and they can only be rescued by concurrent deletion of the TP53 gene (Jones et al. 1995; Montes de Oca et al. 1995).”
BackgroundMDM2, MDMX and p53 in oncogenesis and cancer therapy
Wade, M., Li, Y.-C., & Wahl, G. M. (2013) · Nature Reviews Cancer · doi:10.1038/nrc3430 · Cited by 1,279 · cited 2× · see citing works
“By controlling expression of a large number of genes, the transcription factor p53 plays a vital role in the regulation of many cellular processes, including cell-cycle progression, apoptosis, senescence, DNA repair, and metabolism, and functions as a powerful tumor suppressor (Vousden and Lu 2002; Toledo and Wahl 200…”
BackgroundBond, G. L., Hu, W., Bond, E. E., Robins, H., Lutzker, S. G., Arva, N. C., Bargonetti, J., Bartel, F., Taubert, H., Wuerl, P., et al. (2004) · Cell · doi:10.1016/j.cell.2004.11.022 · Cited by 1,265 · see citing works
The MDM2 gene amplification database
Momand, J. (1998) · Nucleic Acids Research · doi:10.1093/nar/26.15.3453 · Cited by 982 · see citing works
Awakening guardian angels: drugging the p53 pathway
Brown, C. J., Lain, S., Verma, C. S., Fersht, A. R., & Lane, D. P. (2009) · Nature Reviews Cancer · doi:10.1038/nrc2763 · Cited by 881 · see citing works
Structure-based design of potent non-peptide MDM2 inhibitors
Ding, K., Lu, Y., Nikolovska-Coleska, Z., Qiu, S., Ding, Y., Gao, W., Stuckey, J., Krajewski, K., Roller, P. P., Tomita, Y., et al. (2005) · Journal of the American Chemical Society · doi:10.1021/ja051147z · Cited by 657 · see citing works
Self-citationMDMX: a novel p53‐binding protein with some functional properties of MDM2.
Shvarts, A., Steegenga, W. T., Riteco, N., van Laar, T., Dekker, P., Bazuine, M., van Ham, R. C., van der Houven van Oordt, W., Hateboer, G., van der Eb, A. J., et al. (1996) · The EMBO Journal · doi:10.1002/j.1460-2075.1996.tb00919.x · Cited by 648 · see citing works
MDM2 — master regulator of the p53 tumor suppressor protein
Momand, J., Wu, H.-H., & Dasgupta, G. (2000) · Gene · doi:10.1016/s0378-1119(99)00487-4 · Cited by 641 · see citing works
Discovery of RG7388, a Potent and Selective p53–MDM2 Inhibitor in Clinical Development
Ding, Q., Zhang, Z., Liu, J.-J., Jiang, N., Zhang, J., Ross, T. M., Chu, X.-J., Bartkovitz, D., Podlaski, F., Janson, C., et al. (2013) · Journal of Medicinal Chemistry · doi:10.1021/jm400487c · Cited by 595 · see citing works
Functions of the MDM2 oncoprotein
Freedman, D. A., Wu, L., & Levine, A. J. (1999) · Cellular and Molecular Life Sciences · doi:10.1007/s000180050273 · Cited by 573 · see citing works
Ray-Coquard, I., Blay, J.-Y., Italiano, A., Le Cesne, A., Penel, N., Zhi, J., Heil, F., Rueger, R., Graves, B., Ding, M., et al. (2012) · The Lancet Oncology · doi:10.1016/s1470-2045(12)70474-6 · Cited by 571 · see citing works
Kemp, C. J., Donehower, L. A., Bradley, A., & Balmain, A. (1993) · Cell · doi:10.1016/0092-8674(93)90461-x · Cited by 453 · see citing works
Discovery of RG7112: a small-molecule MDM2 inhibitor in clinical development
Vu, B., Wovkulich, P., Pizzolato, G., Lovey, A., Ding, Q., Jiang, N., Liu, J.-J., Zhao, C., Glenn, K., Wen, Y., et al. (2013) · ACS Medicinal Chemistry Letters · doi:10.1021/ml4000657 · Cited by 395 · see citing works
Wang, S., Sun, W., Zhao, Y., McEachern, D., Meaux, I., Barrière, C., Stuckey, J. A., Meagher, J. L., Bai, L., Liu, L., et al. (2014) · Cancer Research · doi:10.1158/0008-5472.can-14-0799 · Cited by 328 · see citing works
Self-citationMDM2 is a Central Node in the p53 Pathway: 12 Years and Counting
Bond, G. L., Hu, W., & Levine, A. J. (2005) · Current Cancer Drug Targets · doi:10.2174/1568009053332627 · Cited by 310 · see citing works
The p53 family in differentiation and tumorigenesis
Stiewe, T. (2007) · Nature Reviews Cancer · doi:10.1038/nrc2072 · Cited by 306 · see citing works
Zhao, Y., Yu, S., Sun, W., Liu, L., Lü, J., McEachern, D., Shargary, S., Bernard, D., Li, X., Zhao, T., et al. (2013) · Journal of Medicinal Chemistry · doi:10.1021/jm4005708 · Cited by 292 · see citing works
Self-citationSun, D., Li, Z., Rew, Y., Gribble, M., Bartberger, M. D., Beck, H. P., Canon, J., Chen, A., Chen, X., Chow, D., et al. (2014) · Journal of Medicinal Chemistry · doi:10.1021/jm401753e · Cited by 290 · see citing works
Weaver, J., Downs-Kelly, E. P., Goldblum, J. R., et al. (2008) · Modern Pathology · doi:10.1038/modpathol.2008.84 · Cited by 274 · see citing works
Garcı́a-Echeverrı́a, C., Chêne, P., Blommers, M. J. J., & Furet, P. (2000) · Journal of Medicinal Chemistry · doi:10.1021/jm990966p · Cited by 246 · see citing works
The Role of MDM2 Amplification and Overexpression in Tumorigenesis
Oliner, J. D., Saiki, A. Y., & Caenepeel, S. (2016) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a026336 · Cited by 246 · see citing works
Diastereomeric spirooxindoles as highly potent and efficacious MDM2 inhibitors
Zhao, Y., Liu, L., Sun, W., Lu, J., McEachern, D., Li, X., Yu, S., Bernard, D., Ochsenbein, P., Ferey, V., et al. (2013) · Journal of the American Chemical Society · doi:10.1021/ja3125417 · Cited by 234 · see citing works
Self-citationHolzer, P., Masuya, K., Furet, P., Kallen, J., Valat-Stachyra, T., Ferretti, S., Berghausen, J., Bouisset-Leonard, M., Buschmann, N., Pissot-Soldermann, C., et al. (2015) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.5b00810 · Cited by 203 · see citing works
Juven‐Gershon, T., & Oren, M. (1999) · Molecular Medicine · doi:10.1007/bf03402141 · Cited by 193 · see citing works
Structure-Based Design of Novel Inhibitors of the MDM2–p53 Interaction
Rew, Y., Sun, D., de Turiso, F. G.-L., Bartberger, M. D., Beck, H. P., Canon, J. R., Chen, A., Chow, D. T., Deignan, J., Fox, B. M., et al. (2012) · Journal of Medicinal Chemistry · doi:10.1021/jm300354j · Cited by 166 · see citing works
Mutational spectrum of p53 mutations in primary breast and ovarian tumors
Feki, A., & Irminger-Finger, I. (2004) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2004.07.002 · Cited by 139 · see citing works
Attenuating the p53 Pathway in Human Cancers: Many Means to the Same EndPreprint
Wasylishen, A. R., & Lozano, G. (2016) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a026211 · Cited by 128 · see citing works
Métay, C., Paillerets, B. B., Lefrère, I., Ronsin, M., Feunteun, J., Tursz, T., & Wiels, J. (1998) · Oncogene · doi:10.1038/sj.onc.1201702 · Cited by 123 · see citing works
Weaver, J., Goldblum, J. R., Turner, S. L., et al. (2008) · Modern Pathology · doi:10.1038/modpathol.2008.153 · Cited by 80 · see citing works
MDM2 induces hyperplasia and premalignant lesions when expressed in the basal layer of the epidermis
Ganguli, G., Abecassis, J., & Wasylyk, B. (2000) · The EMBO Journal · doi:10.1093/emboj/19.19.5135 · Cited by 77 · see citing works
Ordering of the N-Terminus of Human MDM2 by Small Molecule Inhibitors
Michelsen, K., Jordan, J. B., Lewis, J. K., Long, A. M., Yang, E., Rew, Y., Zhou, J., Yakowec, P. S., Schnier, P. D., Huang, X. Y., et al. (2012) · Journal of the American Chemical Society · doi:10.1021/ja305839b · Cited by 71 · see citing works
Siu, L. L., Italiano, A., Miller, W. H., et al. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2014.32.15_suppl.2535 · Cited by 67 · see citing works
Hoffman-Luca, C. G., Ziazadeh, D., McEachern, D., Zhao, Y., Sun, W., Debussche, L., & Wang, S. (2015) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-14-2506 · Cited by 52 · see citing works
Self-citationWatters, J., Dickson, M. A., Schwartz, G. K., et al. (2015) · Journal of Clinical Oncology · doi:10.1200/jco.2015.33.15_suppl.2515 · Cited by 4 · see citing works
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Regulating tumor suppressor genes: post-translational modifications
Chen, L., Liu, S., & Tao, Y. (2020) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-020-0196-9 · Cited by 449 · see citing works
Zhu, H., Gao, H., Ji, Y., Zhou, Q., Du, Z., Tian, L., Jiang, Y., Yao, K., & Zhou, Z. (2022) · Journal of Hematology & Oncology · doi:10.1186/s13045-022-01314-3 · Cited by 223 · see citing works
Therapeutics targeting p53-MDM2 interaction to induce cancer cell death
Koo, N., Sharma, A. K., & Narayan, S. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23095005 · Cited by 153 · see citing works
Homo-PROTAC mediated suicide of MDM2 to treat non-small cell lung cancer
He, S., Ma, J., Fang, Y., Liu, Y., Wu, S., Dong, G., Wang, W., & Sheng, C. (2021) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2020.11.022 · Cited by 91 · see citing works
Geng, C., Vangone, A., Folkers, G. E., Xue, L. C., & Bonvin, A. M. J. J. (2019) · Proteins: Structure, Function, and Bioinformatics · doi:10.1002/prot.25630 · Cited by 82 · see citing works
Potent effect of the MDM2 inhibitor AMG232 on suppression of glioblastoma stem cells
Her, N.-G., Oh, J.-W., Oh, Y. J., Han, S., Cho, H. J., Lee, Y., Ryu, G. H., & Nam, D.-H. (2018) · Cell Death & Disease · doi:10.1038/s41419-018-0825-1 · Cited by 68 · see citing works
Small molecules targeting protein–protein interactions for cancer therapy
Wu, D., Li, Y., Zheng, L., Xiao, H., Ouyang, L., Wang, G., & Sun, Q. (2023) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2023.05.035 · Cited by 71 · see citing works
CDK4 inhibition diminishes p53 activation by MDM2 antagonists
Sriraman, A., Dickmanns, A., Najafova, Z., Johnsen, S. A., & Dobbelstein, M. (2018) · Cell Death & Disease · doi:10.1038/s41419-018-0968-0 · Cited by 40 · see citing works
Protein-Protein Interactions and Aggregation Inhibitors in Alzheimer’s Disease
Ganeshpurkar, A., Swetha, R., Kumar, D., Gangaram, G. P., Singh, R., Gutti, G., Jana, S., Kumar, D., Kumar, A., & Singh, S. K. (2019) · Current Topics in Medicinal Chemistry · doi:10.2174/1568026619666190304153353 · Cited by 30 · see citing works
MDM2 inhibition in the treatment of glioblastoma: From concept to clinical investigation
Pellot Ortiz, K. I., Rechberger, J. S., Nonnenbroich, L. F., Daniels, D. J., & Sarkaria, J. N. (2023) · Biomedicines · doi:10.3390/biomedicines11071879 · Cited by 30 · see citing works
- Authors
- Wang, S., Zhao, Y., Aguilar, A., Bernard, D., & Yang, C.-Y.
- Affiliations
- University of Michigan (US)
- Venue
- Cold Spring Harbor Perspectives in Medicine
- Publisher
- Cold Spring Harbor Laboratory
- Published
- 2017-03-07
- Volume
- 7
- Issue
- 5
- Pages
- a026245
- ISSN
- 2157-1422 (ISSN-L)
- PMC
- PMC5411684
- OpenAlex
- W2594386026
- Cited by
- 300
- References
- 41
- Citations by year
- 2026: 16 · 2025: 29 · 2024: 18 · 2023: 40 · 2022: 44 · 2021: 50 · 2020: 39 · 2019: 30 · 2018: 20 · 2017: 9 · 2016: 3
- Type
- posted content
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cold Spring Harbor Perspectives in Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Susan G. Komen for the Cure
- Prostate Cancer Foundation
- Sanofi
- Ascentage Pharma
- National Institutes of Health
- National Cancer Institute
- Topics
- Health Sciences › Medicine › Oncology › Cancer-related Molecular Pathways
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › PI3K/AKT/mTOR signaling in cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Heat shock proteins research
- Keywords
- MDM2, p53, p53-MDM2 interaction, small molecule inhibitors, p53 reactivation, tumor suppressor function, anticancer drug development, clinical trials, cancer therapy
- MeSH terms
- Animals, Antineoplastic Agents, Humans, Indoles, Neoplasms, Protein Binding, Spiro Compounds, Tumor Suppressor Protein p53, Imidazolines, Proto-Oncogene Proteins c-mdm2
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