INTRODUCTION
Cyclin-dependent kinases (CDKs) regulate cell cycle progression.
Certain CDKs (e.g., CDK7, CDK9) also control cellular transcription.
Consequently, CDKs represent attractive targets for anti-cancer drug
development, as their aberrant expression is common in diverse malignancies,
and CDK inhibition can trigger apoptosis. CDK inhibition may be particularly
successful in hematologic malignancies, which are more sensitive to
inhibition of cell cycling and apoptosis induction.
AREAS COVERED
A number of CDK inhibitors, ranging from pan-CDK inhibitors such as
flavopiridol (alvocidib) to highly selective inhibitors of specific CDKs
(e.g., CDK4/6), such as PD0332991, that are currently in various phases of
development, are profiled in this review. Flavopiridol induces cell cycle
arrest, and globally represses transcription via CDK9 inhibition. The latter
may represent its major mechanism of action via down-regulation of multiple
short-lived proteins. In early phase trials, flavopiridol has shown
encouraging efficacy across a wide spectrum of hematologic malignancies.
Early results with dinaciclib and PD0332991 also appear promising.
EXPERT OPINION
In general, the anti-tumor efficacy of CDK inhibitor monotherapy is
modest, and rational combinations are being explored, including those
involving other targeted agents. While selective CDK4/6 inhibition might be
effective against certain malignancies, broad spectrum CDK inhibition will
likely be required for most cancers.