Survivin for chemotherapy efficacy in gastric cancer

Evangelia Legaki, Emmanouela Rapti, Maria Gazouli

Abstract

Survivin belongs to the inhibitor of apoptosis protein family. Its bi-functional role in apoptosis and in cell division makes it an important molecule for the progress of cancer. Survivin is over-expressed in most malignancies but not in normal differentiated tissues. As far as gastric cancer is concerned, survivin is highly expressed in tumor cells and plays a role in the development of carcinogenesis. High rate of survivin influences overall survival of patients and is correlated with poor prognosis in gastric cancer. Moreover, survivin seems to provide gastric cancer cells with chemo and radio-resistance, similar with other type of cancers. The association between over-expression of survivin and resistance to various chemo-drugs and radiation renders this molecule as a significant biomarker. Survivin is considered as an ideal therapeutic target of cancer due to its capacity to inhibit apoptosis and to promote tumor growth and its selective expression in cancer cells. Since survivin expression might be a useful diagnostic, prognostic, and predictive marker in certain malignancies, many studies aim to counteract survivin in order to inhibit tumor growth and to enhance tumor cell response to apoptosis-inducing anticancer agents. Different approaches are used including antisense oligonucleotides, ribozymes and siRNA, gene therapy through dominant negative mutants, synthetic small molecules and immunotherapy.