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This review summarizes the anti‑cancer mechanisms of nelfinavir and other protease inhibitors. Two main pathways are endoplasmic reticulum stress‑unfolded protein response and Akt inhibition. Additional effects include inhibition of MMP‑2/‑9, downregulation of CDK‑2, VEGF, bFGF, NF‑kB, STAT‑3, HIF‑1α, survivin, androgen receptor, and fatty acid synthase, as well as induction of autophagy and increased radiosensitivity. PIs may be classified as Akt inhibitors, ER stressors, or both. Phase I trials are complete; larger well‑designed trials are needed to establish nelfinavir’s place in cancer therapy.
Fig. 1 A more detailed view of nelfinavir’s action on ER stress. (Koltai T, 2015)
References
In human non‑small cell lung cancer (NSCLC) cell lines and xenograft models, combining nelfinavir (HIV protease inhibitor) with chloroquine (autophagy inhibitor) enhanced endoplasmic reticulum stress, proteotoxicity, and apoptosis compared to either drug alone. The combination significantly inhibited NSCLC cell proliferation in vitro and tumor growth in vivo. Induction of proteotoxicity may represent a promising new target for anticancer drug development.
Fig. 2 Combining nelfinavir (NFV) with chloroquine (CQ) enhances inhibition of non-small cell lung cancer (NSCLC) proliferation and proteotoxicity. (Lopiccolo J, et al., 2021)
References
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