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Emerging therapies targeting the ubiquitin proteasome system in cancer
Nathaniel M. Weathington, Rama K. Mallampalli
Nathaniel M. Weathington, Rama K. Mallampalli
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Science in Medicine

Emerging therapies targeting the ubiquitin proteasome system in cancer

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Abstract

The ubiquitin proteasome system (UPS) is an essential metabolic constituent of cellular physiology that tightly regulates cellular protein concentrations with specificity and precision to optimize cellular function. Inhibition of the proteasome has proven very effective in the treatment of multiple myeloma, and this approach is being tested for utility in other malignancies. New pharmaceuticals targeting the proteasome itself or specific proximal pathways of the UPS are in development as antiproliferatives or immunomodulatory agents. In this article, we discuss the biology of UPS-targeting drugs, their use as therapy for neoplasia, and the state of clinical and preclinical development for emerging therapeutics.

Authors

Nathaniel M. Weathington, Rama K. Mallampalli

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Figure 1

A schematic of the UPS.

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A schematic of the UPS.
Ub is loaded onto the E1 activating enzyme in an...
Ub is loaded onto the E1 activating enzyme in an ATP-dependent fashion and then transferred to an E2 Ub-conjugating enzyme. For the case of cullin-RING E3 ligases, the E3 is primed by neddylation by the NEDD8-activating enzyme (NAE). E3 ligases may be single proteins or multi-subunit enzyme complexes that mediate Ub transfer from an E2 conjugating enzyme to the substrate through interaction of a degron motif (usually a posttranslationally modified molecular recognition signature such as phosphorylation [P]) within the substrate and the binding domain of the E3. Ub monomers are covalently added to the substrate protein, and the polyubiquitinated protein is recognized and bound by the 19S subunit and degraded by the 20S subunit of the 26S proteasome. DUB enzymes are capable of “rescuing” Ub substrates from degradation, while other DUBs mediate cleavage and recycling of the Ub monomers. Components that are potential therapeutic targets are indicated by asterisks.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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