Targeting MDM2-p53 interaction for cancer therapy: are we there yet?

Curr Med Chem. 2014;21(5):553-74. doi: 10.2174/09298673113206660325.


Inactivation of the tumor suppressor p53 and/or overexpression of the oncogene MDM2 frequently occur in human cancers, and are associated with poor prognosis, advanced forms of the disease, and chemoresistance. MDM2, the major negative regulator of p53, induces p53 degradation and inactivates its tumor suppressing activity. In turn, p53 regulates MDM2 expression. This MDM2-p53 negative feedback loop has been widely studied and presents an attractive target for cancer therapy, with a few of the inhibitors of this interaction already having advanced into clinical trials. Additionally, there is an increasing interest in understanding MDM2's p53-independent activities in carcinogenesis and cancer progression, which may also have implications for cancer therapy. This review aims to highlight the various roles that the MDM2-p53 interaction plays in cancer, the p53 independent oncogenic activities of MDM2 and the various strategies that may be used to target MDM2 and the MDM2-p53 interaction. We will summarize the major preclinical and clinical evidences of MDM2 inhibitors for human cancer treatment and make suggestions to further improve efficacy and safety of this interesting class of cancer therapeutics.

Publication types

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

MeSH terms

  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Clinical Trials as Topic
  • Humans
  • Imidazolines / chemistry
  • Imidazolines / therapeutic use
  • Indoles / chemistry
  • Indoles / therapeutic use
  • Neoplasms / drug therapy*
  • Protein Interaction Domains and Motifs / drug effects
  • Proto-Oncogene Proteins c-mdm2 / antagonists & inhibitors
  • Proto-Oncogene Proteins c-mdm2 / metabolism*
  • Small Molecule Libraries / chemistry
  • Small Molecule Libraries / pharmacology
  • Small Molecule Libraries / therapeutic use*
  • Tryptamines / chemistry
  • Tryptamines / therapeutic use
  • Tumor Suppressor Protein p53 / antagonists & inhibitors
  • Tumor Suppressor Protein p53 / metabolism*


  • Antineoplastic Agents
  • Imidazolines
  • Indoles
  • Small Molecule Libraries
  • Tryptamines
  • Tumor Suppressor Protein p53
  • tryptamine
  • MDM2 protein, human
  • Proto-Oncogene Proteins c-mdm2