Life and Death Decision-Making by p53 and Implications for Cancer Immunotherapy

Trends Cancer. 2021 Mar;7(3):226-239. doi: 10.1016/j.trecan.2020.10.005. Epub 2020 Nov 13.

Abstract

The tumor-suppressor protein p53 is mutated in approximately half of all cancers, whereas the p53 signaling network is perturbed in almost all cancers. In response to different stress stimuli, p53 selectively activates genes to elicit a cell survival or cell death response. How p53 makes the decision between life and death remains a fascinating question and an exciting field of research. Understanding how this decision is made has major implications for improving cancer treatments, particularly in recently evolved immune checkpoint inhibition therapy. We highlight progress and challenges in understanding the mechanisms governing the p53 life and death decision-making process, and discuss how this decision is relevant to immune system regulation. Finally, we discuss how knowledge of the p53 pro-survival and pro-death decision node can be applied to optimize immune checkpoint inhibitor therapy for cancer treatment.

Keywords: cancer; cancer immunotherapy; cancer therapeutics; cell death; cell survival; p53.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antigens, Neoplasm / genetics
  • Cell Survival / drug effects
  • Cell Survival / genetics
  • Cell Survival / immunology
  • DNA Damage
  • DNA Repair / drug effects
  • Gene Expression Regulation, Neoplastic / drug effects
  • Gene Expression Regulation, Neoplastic / immunology
  • Humans
  • Immune Checkpoint Inhibitors / pharmacology*
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunogenic Cell Death / drug effects*
  • Immunogenic Cell Death / genetics
  • Immunotherapy, Adoptive / methods*
  • Mice
  • MicroRNAs / metabolism
  • Mutation
  • Neoplasms / genetics
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Protein Processing, Post-Translational
  • Receptors, Chimeric Antigen / immunology
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism*

Substances

  • Antigens, Neoplasm
  • Immune Checkpoint Inhibitors
  • MicroRNAs
  • Receptors, Chimeric Antigen
  • TP53 protein, human
  • Trp53 protein, mouse
  • Tumor Suppressor Protein p53