Heat shock protein 90 is a rational molecular target in breast cancer.

Heat shock protein 90 is a molecular chaperone whose association is required for stability and function of multiple mutated, chimeric, and over-expressed signaling proteins that promote cancer cell growth and/or survival. Hsp90 client proteins important in breast cancer include the estrogen receptor, the serine-threonine kinases Raf-1 and Akt, the receptor tyrosine kinase ErbB2/Neu, and the hypoxia inducible transcription factor HIF-1alpha. Hsp90 small molecule inhibitors, by interacting specifically with a single molecular target, thus promote the destabilization and eventual degradation of multiple cancer cell survival and growth promoting proteins, and these inhibitors have shown promising anti-tumor activity in preclinical breast cancer model systems. One Hsp90 inhibitor, 17-AAG, is currently in Phase I clinical trial. Because of their unique ability to inhibit multiple survival pathways utilized by cancer cells, combination of Hsp90 inhibitors with standard chemotherapeutic agents may dramatically increase in vivo efficacy.