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Molecular pathogenesis of mantle cell lymphoma
Pedro Jares, … , Dolors Colomer, Elias Campo
Pedro Jares, … , Dolors Colomer, Elias Campo
Published October 1, 2012
Citation Information: J Clin Invest. 2012;122(10):3416-3423. https://doi.org/10.1172/JCI61272.
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Review Series

Molecular pathogenesis of mantle cell lymphoma

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Abstract

Mantle cell lymphoma is a B cell malignancy in which constitutive dysregulation of cyclin D1 and the cell cycle, disruption of DNA damage response pathways, and activation of cell survival mechanisms contribute to oncogenesis. A small number of tumors lack cyclin D1 overexpression, suggesting that its dysregulation is always not required for tumor initiation. Some cases have hypermutated IGHV and stable karyotypes, a predominant nonnodal disease, and an indolent clinical evolution, which suggests that they may correspond to distinct subtypes of the disease. In this review, we discuss the molecular pathways that contribute to pathogenesis, and how improved understanding of these molecular mechanisms offers new perspectives for the treatment of patients.

Authors

Pedro Jares, Dolors Colomer, Elias Campo

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Figure 2

Major aberrant pathways in MCL susceptible to targeted therapies.

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Major aberrant pathways in MCL susceptible to targeted therapies.
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Numerous signaling pathways are constitutively activated and/or deregulated in MCL, including BCR, BAFF-R, mTOR, WNT, and NOTCH1 signaling as well as pathways that promote the cell cycle and inhibit apoptosis. mTOR and proteasome inhibitors are the only two pathways for which specific drugs have been approved. Several small molecules targeting the BCR and the PI3K/AKT/mTOR pathway at different levels (indicated by white text) are currently being studied in clinical trials. Other clinical trials are using small molecules to target the BCL2 family proteins directly involved in apoptosis and the cyclin-dependent kinases (CDKs) directly involved in the progression through G1/S and G2/M phases of the cell cycle. The WNT and NOTCH1 pathways are potential targets for β-catenin (β-cat) inhibitors and NOTCH1 inhibitors, respectively. Pharmacologic inhibition of PARP activity has become an interesting therapeutic strategy in tumors with dysfunctional DNA repair mechanisms, such as MCL.
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