Drugs Targeting p53 Mutations with FDA Approval and in Clinical Trials
Open accessAbstract
Mutations in the tumor suppressor p53 (p53) promote cancer progression. This is mainly due to loss of function (LOS) as a tumor suppressor, dominant-negative (DN) activities of missense mutant p53 (mutp53) over wild-type p53 (wtp53), and wtp53-independent oncogenic activities of missense mutp53 by interacting with other tumor suppressors or oncogenes (gain of function: GOF). Since p53 mutations occur in ~50% of human cancers and rarely occur in normal tissues, p53 mutations are cancer-specific and ideal therapeutic targets. Approaches to target p53 mutations include (1) restoration or stabilization of wtp53 conformation from missense mutp53, (2) rescue of p53 nonsense mutations, (3) depletion or degradation of mutp53 proteins, and (4) induction of p53 synthetic lethality or targeting of vulnerabilities imposed by p53 mutations (enhanced YAP/TAZ activities) or deletions (hyperactivated retrotransposons). This review article focuses on clinically available FDA-approved drugs and drugs in clinical trials that target p53 mutations and summarizes their mechanisms of action and activities to suppress cancer progression.
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Potential agents in development for mTP53 MDS/AML exploit diverse mechanisms of action including variant-specific reactivators, agents that induce p53 synthetic lethality, and/or agents targeting vulnerabilities imposed by p53 mutations.
“Potential agents in development for mTP53 MDS/AML exploit diverse mechanisms of action including variant‐specific reactivators (e.g., the Y220C reactivator rezatapopt), agents that can induce p53 synthetic lethality, and/or agents targeting vulnerabilities imposed by p53 mutations.”
From Long‐term follow‐up and combined Phase 2 results of eprenetapopt and azacitidine in patients with <i>TP53</i> mutant MDS/AML (2025) · cites this paper as [53]
The Introduction and §2.3 describe p53 reactivation, synthetic lethality, and targeting vulnerabilities imposed by p53 mutations; §2.1 reports APR-246 trials in TP53-mutated MDS/AML. But the paper does not establish that all these approaches are in development specifically for MDS/AML, and its discussion of a Y220C-specific compound names JC744, not rezatapopt. (LLM, conf=0.87)
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Sallman, D. A., Komrokji, R. S., Dezern, A. E., Sebert, M., Garcia‐Manero, G., Rahmé, R., Winer, E. S., Lehmann‐Che, J., Roboz, G. J., Madelaine, I., et al. (2025) · HemaSphere · doi:10.1002/hem3.70164 · Cited by 20 · see citing works
“53 Development of new drugs and design of clinical trials in this population needs to be focused on event ‐ driven endpoints, even in early phase trials, as response rates in this setting have been poorly predictive of outcomes.”
Functional investigations of p53 acetylation enabled by heterobifunctional molecules
Chen, L.-Y., Singha Roy, S. J., Jadhav, A. M., Wang, W. W., Chen, P.-H., Bishop, T., Erb, M. A., & Parker, C. G. (2024) · ACS Chemical Biology · doi:10.1021/acschembio.4c00438 · Cited by 18 · see citing works
- Authors
- Nishikawa, S., & Iwakuma, T.
- Affiliations
- Children’s Mercy Research Institute (US)
- Corresponding author
- Iwakuma, Tomoo
- Venue
- Cancers
- Publisher
- MDPI AG
- Published
- 2023-01-09
- Volume
- 15
- Issue
- 2
- Pages
- 429
- ISSN
- 2072-6694 (ISSN-L)
- PMC
- PMC9856662
- OpenAlex
- W4313897948
- Cited by
- 115
- References
- 164
- Citations by year
- 2026: 23 · 2025: 40 · 2024: 39 · 2023: 13
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancers (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- NIH (R01 CA214916)
- Braden’s Hope For Childhood Cancer (R01 CA214916)
- Masonic Cancer Alliance (R01 CA214916)
- Topics
- Health Sciences › Medicine › Oncology › Cancer-related Molecular Pathways
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › PI3K/AKT/mTOR signaling in cancer
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cancer Mechanisms and Therapy
- Keywords
- TP53 mutation, dominant-negative p53, gain-of-function p53, p53 degradation, synthetic lethality, YAP/TAZ, retrotransposons, FDA-approved drugs, clinical trials, cancer therapy
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