Role of c-Met in cancer: emphasis on lung cancer.

Lung cancer remains the leading cause of cancer death. It is often diagnosed at late stages and is treated systemically with cytotoxic chemotherapy, which is generally ineffective. Research efforts have focused on developing therapies targeted to growth factor receptor pathways, such as epidermal growth factor receptor (EGFR), but the results from clinical trials overall show very small improvements in survival. Research on signaling pathways dysregulated in lung cancer is ongoing, including investigation of the hepatocyte growth factor receptor (HGFR) or c-Met. Protein tyrosine kinases, such as EGFR and c-Met, are a family of oncogenes that regulate important cellular processes, such as differentiation, proliferation, cell cycle, motility, and apoptosis. Hepatocyte growth factor (HGF), a ligand for c-Met, is secreted by mesodermal cells during development. It produces multiple effects upon binding to its receptor (HGFR/c-Met) and regulates proliferation, motility, mitogenesis, and morphogenesis. Studies in cell lines isolated from various tumors show that several intracellular pathways participate in c-Met signaling, including growth factor receptor-bound protein 2 (Grb2), mitogen-activated protein (MAP) kinase, phosphoinositol 3-kinase (PI3K), and phospholipase C-gamma (PLC-gamma). c-Met is overexpressed in many tumors. However, overexpression may not be sufficient to cause increased activity; the receptor needs to be activated. In some cases, the kinases are constitutively active due to mutations in the gene. The cytoskeletal protein paxillin also appears to be activated along with c-Met. Correlative studies from patient tissue samples and cell lines have rendered the same information, indicating that the signaling pathways dysregulated are complex and interdependent. Mutations in human c-Met have been exogenously expressed in Caenorhabditis elegans, which can serve as a model for determining the role of gene mutations in a whole organism. Several inhibitors of c-Met/HGF binding are in development, including some in phase I trials. Their effectiveness in improving cancer outcomes will be determined in the near future.