Inhibitors of heat shock protein 90 activity: A novel class of tumor radiosensitizers

The 90-kDa heat shock protein (Hsp90) is one of the major chaperones in eukaryotes and catalyzes the maturation and activation of its client proteins. Oncogene products, hormones or growth factor receptors, and key components of signaling pathways are responsible for the malignant growth of tumors or their resistance to chemotherapy and radiotherapy; some of these molecules were identified among the client proteins of Hsp90. Upon the inhibition of Hsp90 chaperone function, such client proteins are inactivated and rapidly degraded, which leads to simultaneous blocking of multiple pathways that are essential for malignant cell proliferation and survival; therefore, pharmacological inhibitors of the Hsp90 chaperone activity could be potentially used in anticancer therapy. Several Hsp90 inhibitors are currently being tested in preclinical or phase I–III clinical trials, either as single agents or in combination with other anticancer drugs or irradiation treatment. In this review, we summarize the data regarding the characterization of Hsp90 inhibitors as efficient radiosensitizers of tumor cells. We also discuss molecular mechanisms and the selectivity of radiosensitization induced by Hsp90 inhibition, as well as a possibility of their application to improve the outcome of radiotherapy.