The Rho-associated (ROCK) serine/threonine kinases have emerged as central regulators of the actomyosin cytoskeleton, their main purpose being to promote contractile force generation. Aided by the discovery of effective inhibitors such as Y27632, their roles in cancer have been extensively explored with particular attention focused on motility, invasion and metastasis. Recent studies have revealed a surprisingly diverse range of functions of ROCK. These insights could change the way ROCK inhibitors might be used in cancer therapy to include the targeting of stromal rather than tumour cells, the concomitant blocking of ROCK and proteasome activity in K-Ras-driven lung cancers and the combination of ROCK with tyrosine kinase inhibitors for treating haematological malignancies such as chronic myeloid leukaemia. Despite initial optimism for therapeutic efficacy of ROCK inhibition for cancer treatment, no compounds have progressed into standard therapy so far. However, by carefully defining the key cancer types and expanding the appreciation of ROCK's role in cancer beyond being a cell-autonomous promoter of tumour cell invasion and metastasis, the early promise of ROCK inhibitors for cancer therapy might still be realized. Keywords: ROCK; actin; cytoskeleton; inhibitor; cancer EMBO reports (2012) 13, 900-908; published online 11 September 2012; doi:10.1038/embor.2012 See the Glossary for abbreviations used in this article.
IntroductionThe Rho GTPase family is best known for its well-characterized roles in regulation of actin cytoskeleton organization and dynamics [1]. The actions of Rho proteins are mediated by effector proteins, which might have intrinsic catalytic activity, act as scaffolds for protein complexes and in some instances serve both functions [2]. The RhoA and RhoC family members act primarily to promote actomyosin contractile force generation through ROCK1-and ROCK2-mediated phosphorylation of numerous downstream target proteins, including LIM kinases 1 and 2 (LIMK1 and LIMK2), the myosin regulatory light chain (MLC), and the myosin binding subunit (MYPT1) of the MLC phosphatase to inhibit catalytic activity and consequent MLC dephosphorylation (Fig 1; [3,4]). Collectively, these events promote actin filament stabilization through LIMKmediated phosphorylation and inactivation of cofilin family proteins, and through MLC phosphorylation leading to increased actin filament bundling and myosin-driven contraction. The increase in actomyosin contractility contributes directly to several proximal processes, such as regulation of morphology, motility, and cell-cell and cell-matrix adhesion. In addition, ROCK kinases influence more distal cellular processes including gene transcription, proliferation, differentiation, apoptosis and oncogenic transformation, although in many instances the molecular mechanisms have not been fully characterized. Given the wide spectrum of biological processes influenced by ROCK, it is not surprising that they have been implicated in numerous aspects of cancer. Reinforcing this a...