The tumor microenvironment plays a central role in cancer progression and metastasis.Within this environment, cancer cells respond to a host of signals including growth factors and chemotactic factors, as well as signals from adjacent cells, cells in the surrounding stroma, and signals from the extracellular matrix. Targeting the pathways that mediate many of these signals has been a major goal in the effort to develop therapeutics.
Integrin Signals and CancerIntegrins constitute the primary set of receptors for extracellular matrix (ECM) components within the tumor microenvironment, and integrin expression is often modulated during cancer progression and metastasis (1 -6). Integrins are heterodimeric transmembrane receptors that link the cell to the ECM by direct binding to the actin cytoskeleton through a scaffold of several actin-binding proteins (7). Thus, they serve as sites of contact between the cell and the ECM. In adherent cells such as fibroblasts, these sites of contact are termed focal adhesions (8). Focal adhesions serve as nodes to transmit environmental signals initiated by soluble growth factors, ECM, and surrounding mechanical forces to regulate cell growth and migration (9 -11). Within tumors, cancer cells respond to changes in the expression and organization of matrix proteins such as fibronectin and collagen. In addition, tumor cells secrete proteases that cleave ECM molecules (metalloproteases) providing both growth-promoting remodeling of the tumor microenvironment and escape of tumor cells through the basement membrane (12).Tyrosine protein kinases play a key role in regulating signals mediated by integrin receptors (13,14). A central regulator of integrin signaling is focal adhesion kinase (FAK), a ubiquitously expressed nonreceptor tyrosine protein kinase (15). FAK expression is required for many normal cellular functions (16) and its expression is up-regulated in a variety of late-stage cancers (16 -19). Here we review the role of FAK in promoting integrin and growth factor signals and its link to cancer progression. We also discuss experiments validating FAK as a therapeutic target, summarize the current state of development of small-molecule inhibitors of FAK, and report progress in assessing such inhibitors in human clinical trials.FAK structure and regulation. FAK is recruited to focal adhesions and activated upon integrin engagement with the ECM (15, 16). The overall molecular structure of FAK is consistent with its function as a protein scaffold, in addition to its function as a tyrosine kinase. The central catalytic domain is flanked upon the NH 2 terminus by a FERM domain and COOH-terminal proline-rich and focal adhesion targeting domains (Fig. 1A). The FERM domain has been reported to serve as a site of interaction with a variety of molecules including integrin cytoplasmic domains, ezrin, Arp2/3, p53, and membrane receptors (13,15). The COOH-terminal domain functions as a scaffold with two proline-rich protein interaction domains (PR-I, PR-II) and a focal adhesion targe...