癌症仍然是一个巨大的全球健康挑战。其发病率和死亡率持续反映了其重大影响。精确肿瘤学的出现为靶向以前被认为是常规疗法和限制脱靶细胞毒性的“不可药用”的致癌驱动因素提供了突破。已经彻底改变了精确肿瘤学领域的两种突破性技术主要是CRISPR-Cas9基因编辑和最近的PROTAC(PROteolidTArgetingChimeras)靶向蛋白质降解技术。特别是CRISPR-Cas9,由于其精确修饰DNA序列的卓越能力,获得了广泛的认可和赞誉。而不是编辑遗传密码,PROTACs利用泛素蛋白酶体降解机制来选择性地降解感兴趣的蛋白质。尽管CRISPR-Cas9和PROTAC技术的原理不同,他们的共同目标是推进精准肿瘤学,这两种方法在临床前和临床试验中都显示出巨大的潜力.CRISPR-Cas9已经证明了其在这一领域的临床潜力,由于其能够直接和间接地修饰基因,高效,可逆,适应性强,和组织特异性方式,以及它作为诊断工具的潜力。另一方面,口服低剂量给药的能力,广泛瞄准,组织特异性,和可控性增强了PROTAC的临床潜力。因此,在精准肿瘤学领域,使用CRISPR技术的基因编辑彻底改变了针对性的干预措施,虽然PROTACs的出现通过实现选择性蛋白质降解进一步扩大了治疗领域。与其将它们视为精确肿瘤学领域中相互排斥或竞争的方法,它们的使用是上下文相关的(即,基于疾病的分子机制),它们可能可以协同使用,以补充CRISPR的优势,反之亦然。在这里,我们回顾了CRISPR和PROTAC设计的现状,以及它们在精确肿瘤学领域的临床潜力,临床试验数据,局限性,并比较它们在精确临床肿瘤学中的意义。
Cancer continues to present a substantial global health challenge, with its incidence and mortality rates persistently reflecting its significant impact. The emergence of precision oncology has provided a breakthrough in targeting oncogenic drivers previously deemed \"undruggable\" by conventional therapeutics and by limiting off-target cytotoxicity. Two groundbreaking technologies that have revolutionized the field of precision oncology are primarily CRISPR-Cas9 gene editing and more recently PROTAC (PROteolysis TArgeting Chimeras) targeted protein degradation technology. CRISPR-Cas9, in particular, has gained widespread recognition and acclaim due to its remarkable ability to modify DNA sequences precisely. Rather than editing the genetic code, PROTACs harness the ubiquitin proteasome degradation machinery to degrade proteins of interest selectively. Even though CRISPR-Cas9 and PROTAC technologies operate on different principles, they share a common goal of advancing precision oncology whereby both approaches have demonstrated remarkable potential in preclinical and promising data in clinical trials. CRISPR-Cas9 has demonstrated its clinical potential in this field due to its ability to modify genes directly and indirectly in a precise, efficient, reversible, adaptable, and tissue-specific manner, and its potential as a diagnostic tool. On the other hand, the ability to administer in low doses orally, broad targeting, tissue specificity, and controllability have reinforced the clinical potential of PROTAC. Thus, in the field of precision oncology, gene editing using CRISPR technology has revolutionized targeted interventions, while the emergence of PROTACs has further expanded the therapeutic landscape by enabling selective protein degradation. Rather than viewing them as mutually exclusive or competing methods in the field of precision oncology, their use is context-dependent (i.e., based on the molecular mechanisms of the disease) and they potentially could be used synergistically complementing the strengths of CRISPR and vice versa. Herein, we review the current status of CRISPR and PROTAC designs and their implications in the field of precision oncology in terms of clinical potential, clinical trial data, limitations, and compare their implications in precision clinical oncology.