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Targeting the Keap1/Nrf2 axis in cancer: molecular mechanisms and pharmacological interventions

Authors: Yangchen Xia,Ziyang Xu,Xun Yuan,Qian Chu
Journal: Investigational New Drugs
Publisher: Springer Science and Business Media LLC
Publish date: 2025-8
ISSN: 0167-6997 DOI: 10.1007/s10637-025-01578-9
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On page 9, you clearly state that an ARE-directed PROTAC would likely degrade the entire sMAF family, including the essential transcription factors NRF1 and NRF3…. You rightly point out that this would cause a spectrum of off-target effects.

But then, the paper still seems to promote this as a promising therapeutic direction. This has me scratching my head.

Could you clarify how a therapeutic strategy that indiscriminately wipes out NRF1, a protein essential for basal cellular homeostasis, mitochondrial function, and is even lethal if knocked out in models, could ever be viable?

It feels like proposing to fix a broken window by burning down the whole house. The on-target toxicity would surely be unacceptable. Doesn’t this fundamental flaw completely undermine the clinical potential of this specific PROTAC approach, rather than just being a “hurdle to overcome”?

Thanks for any insight you can provide

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