Targeting the Substance P/Neurokinin-1 Receptor Axis: A Novel Avenue in Overcoming Cancer Resistance

Authors

  • Riffat Mehboob Cell and Developmental Biology Center, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Miguel Munoz Research Laboratory on Neuropeptides, Institute of Biomedicine of Seville (IBIS), Spain

DOI:

https://doi.org/10.54393/pjhs.v6i7.3401

Abstract

The role of the Substance P (SP)/Neurokinin-1 Receptor (NK-1R) system in cancer biology has gained growing recognition. Recent literature consistently supports its implication in cancer promotion, progression, resistance, and inflammation [1]. SP is a peptide of the tachykinin family involved in multiple pathophysiological mechanisms, including nociception, inflammation, and immune modulation. However, its pathological role particularly through its preferred receptor, NK-1R has become increasingly evident in several malignancies [2].

Numerous studies have shown that SP and NK-1R is overexpressed in human cancer cells and NK-1R is essential for the viability of cancer cells. Activation of NK-1R, either constitutively or through SP binding, promotes cancer cell proliferation, antiapoptotic, survival, Warburg effect, angiogenesis, invasion and migration for metastasis [1]. Furthermore, this pathway contributes significantly to the establishment of a pro-inflammatory microenvironment, which sustains tumor progression. In head and neck cancers—especially laryngeal and oral squamous cell carcinomas the SP/NK-1R system has been implicated in the transition from chronic inflammation to preneoplastic and neoplastic lesions [3, 4]. Beyond its role in cancer progression, the SP/NK-1R axis is also associated with resistance to oncologic treatments. Overriding or malfunctioning NK-1R signaling appears to interfere with treatment response through modulation of signaling cascades and cross-talk with other receptor systems, potentially affecting immune escape and chemoresistance. This has opened the door to drug repurposing strategies involving NK-1R antagonists [5, 6].

Aprepitant, a well-known NK-1R antagonist currently approved for chemotherapy-induced nausea and vomiting, has shown potential in preclinical studies as an antitumor drug. It exhibits antiproliferative, pro-apoptotic, anti-Warburg effect, antiangiogenic, prevent invasion and migration, and has anti-inflammatory effects in cancer models [1, 6]. Importantly, aprepitant’s established safety profile and widespread availability make it a promising candidate for repositioning in oncology [1, 6]. The current evidence suggests that combining NK-1R antagonists with existing therapies could improve treatment response and potentially overcome resistance in multiple cancer types [3, 6]. Despite this progress, more precise characterization of NK-1R’s role across different tumors is needed. NK-1R signals through various pathways, and its full and truncated isoforms may exert distinct functions. Understanding these nuances will be critical for optimizing the clinical use of NK-1R-targeted therapies. Moreover, the availability of selective antagonists and the emerging potential for biased ligands based on receptor structural states present exciting research and therapeutic opportunities [6].

In conclusion, the SP/NK-1R system represents a multifaceted target in cancer biology. Its involvement in carcinogenesis, inflammation, and resistance mechanisms positions it as a valuable focus for novel cancer therapies. Future research should seek to translate these findings into clinical strategies, which could transform cancer care through these new drugs. In addition, the drug aprepitant and other similar drugs should be repurposed as antitumor drugs in cancer therapy.

References

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Garcia-Recio S and Gascón P. Biological and Pharmacological Aspects of the NK1‐Receptor. Biomed Research International. 2015; 2015(1): 495704. doi: 10.1155/2015/495704.

García-Aranda M, Téllez T, McKenna L, Redondo M. Neurokinin-1 Receptor (NK-1R) Antagonists as A New Strategy to Overcome Cancer Resistance. Cancers. 2022 Apr; 14(9): 2255. doi: 10.3390/cancers14092255.

Esteban F, Ramos-Garcia P, Munoz M, Gonzalez-Moles MA. Substance P and Neurokinin 1 Receptor in Chronic Inflammation and Cancer of the Head And Neck: A Review of the Literature. International Journal of Environmental Research and Public Health. 2021 Dec; 19(1): 375. doi: 10.3390/ijerph19010375.

Rodríguez FD and Covenas R. Association of Neurokinin-1 receptor signaling pathways with cancer. Current Medicinal Chemistry. 2024; 31(39): 6460-86. doi: 10.2174/0929867331666230818110812.

Coveñas R, Rodríguez FD, Robinson P, Muñoz M. The Repurposing of Non-Peptide Neurokinin-1 Receptor Antagonists as Antitumor Drugs: An Urgent Challenge for Aprepitant. International Journal of Molecular Sciences. 2023 Nov; 24(21): 15936. doi: 10.3390/ijms242115936.

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Published

2025-07-31
CITATION
DOI: 10.54393/pjhs.v6i7.3401
Published: 2025-07-31

How to Cite

Mehboob, R., & Munoz, M. (2025). Targeting the Substance P/Neurokinin-1 Receptor Axis: A Novel Avenue in Overcoming Cancer Resistance. Pakistan Journal of Health Sciences, 6(7), 01–02. https://doi.org/10.54393/pjhs.v6i7.3401

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