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DRUG CLASS:

Notch-3 receptor inhibitor

2ms
AL101 Before Surgery for the Treatment of Notch Activated Adenoid Cystic Cancer (clinicaltrials.gov)
P1, N=14, Active, not recruiting, M.D. Anderson Cancer Center | Recruiting --> Active, not recruiting
Enrollment closed
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AL101
7ms
AL101 Before Surgery for the Treatment of Notch Activated Adenoid Cystic Cancer (clinicaltrials.gov)
P1, N=14, Recruiting, M.D. Anderson Cancer Center | Trial completion date: Dec 2024 --> Dec 2025 | Trial primary completion date: Dec 2024 --> Dec 2025
Trial completion date • Trial primary completion date
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AL101
10ms
TENACITY: A Study of AL101 Monotherapy in Patients With Notch Activated Triple Negative Breast Cancer (clinicaltrials.gov)
P2, N=18, Terminated, Ayala Pharmaceuticals, Inc, | N=67 --> 18 | Active, not recruiting --> Terminated; Sponsor's decision
Enrollment change • Trial termination
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HER-2 (Human epidermal growth factor receptor 2) • PGR (Progesterone receptor)
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HER-2 negative
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AL101
11ms
ACCURACY: A Study Of AL101In Patients With Adenoid Cystic Carcinoma (ACC) Bearing Activating Notch Mutations (clinicaltrials.gov)
P2, N=87, Completed, Ayala Pharmaceuticals, Inc, | Active, not recruiting --> Completed
Trial completion
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AL101
12ms
NOTCH3 inhibits transcription factor ZEB1 expression and metastasis of breast cancer cells via transcriptionally upregulating miR-223. (PubMed, J Cancer)
Clinically, high expression of NOTCH3, miR-223 or low expression of ZEB1 were related to good prognosis of breast cancer patients. The current study reports a novel NOTCH3/miR-223/ZEB1 axis, which can inhibit the proliferation and invasion of breast cancer cells, and may serve as a potential biomarker for the prognosis of breast cancer.
Journal
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NOTCH3 (Notch Receptor 3) • TGFB1 (Transforming Growth Factor Beta 1) • MIR223 (MicroRNA 223) • ZEB1 (Zinc Finger E-box Binding Homeobox 1)
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NOTCH3 expression • NOTCH3 overexpression • ZEB1 expression
over1year
AL101 therapy in patients with recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC): Final ACCURACY trial results and meta-analysis of clinical outcomes (ESMO 2023)
*Inverse variance method, no transformation, 0.5 continuity correction. ORR: CR + PR; DCR: CR + PR + SD Conclusions AL101 showed acceptable safety and tolerability in ACC pts with Notchmut and a response rate comparable to pooled estimates for available therapies in pts regardless of Notch status.
Clinical data • Retrospective data • Metastases
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NOTCH1 (Notch 1)
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NOTCH mutation
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AL101
over1year
Efficacy of NOTCH inhibitors (Ni) relative to prior systemic therapy or observation in patients (pts) with recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC) (ESMO 2023)
Ni included AL101, a gamma-secretase inhibitor, or OMP-52M51, an antibody targeting N1...The efficacy of Ni compares favorably with efficacy of systemic therapies administered prior to Ni. The limited PFS and high rate of tumor progression on non-target lesions suggests Ni combination therapy may be necessary to address ACC heterogeneity.
Clinical • Metastases
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NOTCH1 (Notch 1)
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AL101 • brontictuzumab (OMP-52M51)
almost2years
Total flavonoids of Litchi seed attenuate stem cell-like properties in breast cancer by regulating Notch3 signaling pathway. (PubMed, J Ethnopharmacol)
TFLS could suppress the growth of breast cancer and eliminate breast cancer stem cells by inhibiting the Notch3 signaling pathway.
Journal
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NOTCH3 (Notch Receptor 3) • SOX2 • CD24 (CD24 Molecule) • POU5F1 (POU Class 5 Homeobox 1) • HES1 (Hes Family BHLH Transcription Factor 1) • NANOG (Nanog Homeobox) • RUNX2 (RUNX Family Transcription Factor 2)
2years
TKF, a mexicanolide-type limonoid derivative, suppressed hepatic stellate cells activation and liver fibrosis through inhibition of the YAP/Notch3 pathway. (PubMed, Phytomedicine)
The therapeutic benefit of TKF against liver fibrosis results from inhibition of YAP and Notch3-Hes1 pathways, indicating that TKF may be a novel therapeutic candidate for liver fibrosis.
Journal
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NOTCH3 (Notch Receptor 3) • ACTA2 (Actin Alpha 2 Smooth Muscle) • TIMP1 (Tissue inhibitor of metalloproteinases 1) • COL1A1 (Collagen Type I Alpha 1 Chain) • HES1 (Hes Family BHLH Transcription Factor 1)
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KIM1 expression • NOTCH3 expression
over2years
AL101, a gamma-secretase inhibitor, has potent antitumor activity against adenoid cystic carcinoma with activated NOTCH signaling. (PubMed, Cell Death Dis)
Here, we describe the antitumor activity of AL101 using ACC cell lines, organoids, and patient-derived xenograft models. Specifically, we find that AL101 has potent antitumor effects in in vitro and in vivo models of ACC with activating NOTCH1 mutations and constitutively upregulated NOTCH signaling pathway, providing a strong rationale for evaluation of AL101 in clinical trials for patients with NOTCH-driven relapsed/refractory ACC.
Journal
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NOTCH1 (Notch 1)
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NOTCH1 mutation • NOTCH mutation
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AL101
over2years
Notch3 signaling between myeloma cells and osteocytes in the tumor niche promotes tumor growth and bone destruction. (PubMed, Neoplasia)
Lastly, mice injected with Notch3 knock-down MM cells had a 50% decrease in tumor burden and a 50% reduction in osteolytic lesions than mice bearing control MM cells. Together, these findings identify Notch3 as a mediator of cell communication among MM cells and between MM cells and osteocytes in the MM tumor niche and warrant future studies to exploit Notch3 as a therapeutic target to treat MM.
Journal
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NOTCH2 (Notch 2) • NOTCH3 (Notch Receptor 3) • SDC1 (Syndecan 1) • TNFSF11 (TNF Superfamily Member 11)
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NOTCH3 expression
over2years
Bruceine H Mediates EGFR-TKI Drug Persistence in NSCLC by Notch3-Dependent β-Catenin Activating FOXO3a Signaling. (PubMed, Front Oncol)
We confirmed that EGFR-TKI in combination with Notch3 inhibitor can inhibit the expression of β-catenin and enhance the level of FOXO3a, leading to improved recurrence-free survival and overall survival of the xenotransplantation model. These results support that the combination of gefitinib and bruceine H may provide a promising alternative strategy for treating acquired EGFR-TKI resistance in patients with NSCLC.
Journal
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EGFR (Epidermal growth factor receptor) • CTNNB1 (Catenin (cadherin-associated protein), beta 1) • NOTCH3 (Notch Receptor 3) • FOXO3 (Forkhead box O3)
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EGFR mutation
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gefitinib
over2years
TENACITY: A Study of AL101 Monotherapy in Patients With Notch Activated Triple Negative Breast Cancer (clinicaltrials.gov)
P2, N=67, Active, not recruiting, Ayala Pharmaceuticals, Inc, | Recruiting --> Active, not recruiting
Enrollment closed
|
HER-2 (Human epidermal growth factor receptor 2) • PGR (Progesterone receptor)
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HER-2 negative
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AL101
over2years
Genetic heterogeneity and therapeutic target detection through microdissection in solid-type adenoid cystic carcinoma. (PubMed, Pathology)
Guided by the genetic profiles, the preclinical efficiency of the gamma-secretase inhibitor BMS-906024 was evaluated in patient derived xenograft models (PDXs) with activating NOTCH1 mutations and demonstrated robust antitumour effects...In contrast to cribriform/tubular ACCs, solid-type ACCs should be approached with a distinct therapeutic strategy, particularly targeting NOTCH1. Microdissecting the highest grade component guided by histology is a highly recommended tumour sampling strategy and facilitates the detection of key molecular targets.
Journal • BRCA Biomarker
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BRCA2 (Breast cancer 2, early onset) • FGFR2 (Fibroblast growth factor receptor 2) • NOTCH1 (Notch 1) • NOTCH2 (Notch 2) • BCOR (BCL6 Corepressor) • NICD (NOTCH1 intracellular domain)
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BRCA2 mutation • FGFR2 mutation • NOTCH1 mutation • BCOR mutation • NICD expression
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AL101
almost3years
OKN-007 Alters Protein Expression Profiles in High-Grade Gliomas: Mass Spectral Analysis of Blood Sera. (PubMed, Brain Sci)
Combined with the chemotherapeutic agent temozolomide (TMZ), OKN-007 is even more effective by affecting chemo-resistant tumor cells. These findings, in general, support our previous gene analysis, indicating that OKN-007 may be effective against the ECM. These findings also surmise that OKN-007 may be more effective against oligodendrogliomas, other brain tumors such as medulloblastoma, and possibly other types of cancers.
Journal
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KMT2D (Lysine Methyltransferase 2D) • NOTCH3 (Notch Receptor 3)
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temozolomide • disufenton sodium (OKN-007)
almost3years
The Association between NOTCH3 expression and the clinical outcome in the urothelial bladder cancer patients. (PubMed, Bosn J Basic Med Sci)
NOTCH3 expression was not a statistically significant predictor of recurrence-free survival (p=0.816). This study indicated that NOTCH3 is a predictor of poor outcome, suggesting that the NOTCH3 could be potentially reliable IHC marker for selecting the UBC patients that would require more intensive follow-up, especially if they diagnosed in higher stage, with divergent differentiation in pathological report, and without recurrences which would lead them to more frequent medical assessments.
Clinical data • Journal
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NOTCH3 (Notch Receptor 3)
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NOTCH3 expression
almost3years
Case series of congenital pseudarthrosis of the tibia unfulfilling neurofibromatosis type 1 diagnosis: 21% with somatic NF1 haploinsufficiency in the periosteum. (PubMed, Hum Genet)
In conclusion, we detected evident somatic mono-allelic NF1 inactivation in the non-NF1-CPT. Thus, for pediatric patients without NF1 diagnosis, somatic mutations in NF1 are important.
Clinical • Journal
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NF1 (Neurofibromin 1) • AKT1 (V-akt murine thymoma viral oncogene homolog 1) • PDGFRB (Platelet Derived Growth Factor Receptor Beta) • NOTCH3 (Notch Receptor 3) • GNAS (GNAS Complex Locus)
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NF1 mutation
almost3years
KCNQ1OT1 affects cell proliferation, invasion, and migration through a miR-34a / Notch3 axis in breast cancer. (PubMed, Environ Sci Pollut Res Int)
We identified a KCNQ1OT1/miR-34a/Notch3 axis which promotes BC progression through effects on cell proliferation and metastasis that was further associated with poor patient prognosis. These results propose targeting this axis as novel treatment approach for BC.
Journal
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NOTCH3 (Notch Receptor 3) • MIR34A (MicroRNA 34a-5p) • KCNQ1OT1 (KCNQ1 Opposite Strand/Antisense Transcript 1)
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NOTCH3 expression
almost3years
GFI1 cooperates with IKZF1/IKAROS to activate gene expression in T-cell acute lymphoblastic leukemia. (PubMed, Mol Cancer Res)
These results identify a non-canonical transcriptional control mechanism in T-ALL which supports GFI1-mediated transactivation in partnership with IKAROS and suggest competition between LSD1-containing repressive complexes and others favoring transactivation. Implications: Combinatorial diversity and cooperation between DNA binding proteins and complexes assembled by them can direct context-dependent transcriptional outputs to control cell fate and may offer new insights for therapeutic targeting in cancer.
Journal
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IKZF1 (IKAROS Family Zinc Finger 1) • NOTCH3 (Notch Receptor 3) • GFI1 (Growth Factor Independent 1 Transcriptional Repressor)
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IKZF2 expression • NOTCH3 expression
almost3years
miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma. (PubMed, Horm Mol Biol Clin Investig)
Our study demonstrated main role of miR-515, miR-623 and miR-1272 in HCC pathogenesis and similarly disclosed that these genes expression could be utilized in HCC prognosis.
Journal
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NOTCH3 (Notch Receptor 3)
3years
Downregulation of Notch3 links TIMP3 inhibition to suppress aggressive phenotypes of pancreatic ductal adenocarcinoma. (PubMed, Am J Cancer Res)
Pancreatic ductal adenocarcinoma (PDAC), one of the most deadly digestive cancers, has a poor 5-year survival rate and is resistant to chemotherapeutic agents, such as gemcitabine...We also found a positive correlation between Notch3 mRNA expression and TIMP3 expression in patients with PDAC. We concluded that blocking Notch3/TIMP3 pathway could considered a potentially new therapeutic strategy for treating PDAC.
Journal
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NOTCH3 (Notch Receptor 3)
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HAVCR2 expression • NOTCH3 expression
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gemcitabine
3years
PD-L1 and Notch as novel biomarkers in Pancreatic Sarcomatoid Carcinoma: a pilot study. (PubMed, Expert Opin Ther Targets)
Our data identify a unique biological characterization of this rare pancreatic histotype. These findings provide a rationale for future studies evaluating the potential crosstalk between PD-L1/PD-1 axis and Notch pathways and prompting the development of novel therapeutics strategy.
Clinical • Journal • PD(L)-1 Biomarker • IO biomarker
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PD-L1 (Programmed death ligand 1) • NOTCH1 (Notch 1) • NOTCH3 (Notch Receptor 3)
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PD-L1 expression • PD-L1 overexpression • NOTCH1 expression • NOTCH3 expression
3years
LncRNA BASP1-AS1 interact with YBX1 to regulate Notch transcription and drives the malignancy of melanoma. (PubMed, Cancer Sci)
The activation of the Notch signaling then resulted in the transcription of multiple oncogenes, including c-MYC, PCNA, CDK4, which contributed to melanoma progression. Thus, BASP1-AS1 could act as a potential biomarker for cutaneous malignant melanoma.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • CDK4 (Cyclin-dependent kinase 4) • NOTCH3 (Notch Receptor 3) • PCNA (Proliferating cell nuclear antigen) • YBX1 (Y-Box Binding Protein 1)
3years
Hsa_circ_NOTCH3 regulates ZNF146 through sponge adsorption of miR-875-5p to promote tumorigenesis of hepatocellular carcinoma. (PubMed, J Gastrointest Oncol)
Overexpression of circ_NOTCH3 evidently overturned the diminishing influence of miR-875-5p mimics on HCC cells. As an oncogene, circ_NOTCH3 can trigger the proliferation, invasion, migration, and oxaliplatin resistance of HCC cells through the miR-875-5p/ZNF146 axis, and may be a promising target for the treatment of HCC.
Journal
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NOTCH3 (Notch Receptor 3)
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NOTCH3 expression
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oxaliplatin
3years
Long non-coding RNA HAGLROS regulates the proliferation, migration, and apoptosis of esophageal cancer cells via the HAGLROS-miR-206-NOTCH3 axis. (PubMed, J Gastrointest Oncol)
HAGLROS participates in the HAGLROS/miR-206/NOTCH3 regulatory axis in EC cells. HAGLROS may play a role in the progression of EC by modulating the miR-206/NOTCH3 signaling axis, and may be a novel target for the diagnosis and treatment of EC.
Journal
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NOTCH3 (Notch Receptor 3) • MIR206 (MicroRNA 206)
3years
The role of distinct BRD4 isoforms and their contribution to high-grade serous ovarian carcinoma pathogenesis. (PubMed, Mol Cancer)
In addition, newly emerging data revealed that BRD4 isoforms exhibit contradicting functions in cancer. Therefore, it is paramount to expand studies elucidating distinct roles of BRD4-L and BRD4-S in HGSOC, which has important implications on development of therapeutic approaches targeting BRD4.
Review • Journal
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NRG1 (Neuregulin 1) • NOTCH3 (Notch Receptor 3) • BRD4 (Bromodomain Containing 4)
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MYC expression
3years
HES5 Activates Long Noncoding RNA UCA1 to Induce Colorectal Cancer Progression by Modulating miR-185/NOTCH3 Signaling. (PubMed, Gastroenterol Res Pract)
In conclusion, UCA1 is a direct target of HES5. UCA1 promotes CRC metastasis through regulating the miR-185/NOTCH3 axis.
Journal
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NOTCH3 (Notch Receptor 3) • miR-185 (MicroRNA 185)
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NOTCH3 expression
3years
Activity of the Gamma Secretase Inhibitor AL101 in Desmoid Tumors: A Case Report of 2 Adult Cases. (PubMed, Curr Oncol)
Also, in a phase 1 study of AL102, a potent orally administered gamma secretase inhibitor that shares structural features with AL101, a patient with a desmoid tumor was noted to have tumor shrinkage. Formal clinical testing of AL102 for the treatment of patients with desmoid tumors that are not amenable to surgery or are refractory to/recurrent from other prior therapies is currently underway.
Clinical • Journal
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CTNNB1 (Catenin (cadherin-associated protein), beta 1)
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AL101 • varegacestat (AL102)
3years
NOTCH3 rs1043996 Polymorphism Is Associated with the Occurrence of Alcoholic Liver Cirrhosis Independently of PNPLA3 and TM6SF2 Polymorphisms. (PubMed, J Clin Med)
Cirrhotic patients with the PNPLA3 GG genotype demonstrated higher activity of ALT aminotransferases than patients with CC or CG genotypes. The susceptibility to the development of HCC in ALC was significantly associated with PNPLA3 rs738409 and EGF rs4444903 polymorphisms, and logistic regression confirmed these polymorphisms as independent predictors.
Journal
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NOTCH1 (Notch 1) • NOTCH3 (Notch Receptor 3) • MTHFR (Methylenetetrahydrofolate Reductase) • NOTCH4 (Notch 4)
3years
Multifaceted targeting strategies in cancer against the human notch 3 protein: a computational study. (PubMed, In Silico Pharmacol)
In essence, the inhibitory activity of the hit was validated across 109 NSCLC cell lines by employing a deep neural network algorithm. Our study proposes that ZINC000013449462 would be a possible prototype molecule towards the notch 3 target and further examined by clinical studies to combat NSCLC.
Journal
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NOTCH3 (Notch Receptor 3)
3years
Elevated expression of nuclear receptor-binding SET domain 3 promotes pancreatic cancer cell growth. (PubMed, Cell Death Dis)
In vivo, intratumoral injection of adeno-associated virus (AAV)-packed NSD3 shRNA potently inhibited pancreatic cancer xenograft growth in nude mice. These results suggest that elevated NSD3 could be an important driver for the malignant progression of pancreatic cancer.
Journal
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NOTCH3 (Notch Receptor 3) • NSD3 (Nuclear Receptor Binding SET Domain Protein 3)
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MYC expression
3years
Identification of the Role and Clinical Prognostic Value of Target Genes of m6A RNA Methylation Regulators in Glioma. (PubMed, Front Cell Dev Biol)
Our study established and validated a seven-gene signature comprising METTL3, COL18A1, NASP, PHLPP2, TIMP1, U2AF2, and VEGFA, with a good capability for predicting glioma survival, which may guide therapeutic customization and clinical decision-making. These genes were identified to influence 81 anticancer drug responses, which further contributes to the early phase clinical trials of drug development.
Clinical • Journal
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DLL3 (Delta Like Canonical Notch Ligand 3) • NOTCH3 (Notch Receptor 3) • TIMP1 (Tissue inhibitor of metalloproteinases 1) • HES1 (Hes Family BHLH Transcription Factor 1) • IGF2BP2 (Insulin Like Growth Factor 2 MRNA Binding Protein 2) • METTL3 (Methyltransferase Like 3)
3years
Germline mutation analyses of malignant ground glass opacity nodules in non-smoking lung adenocarcinoma patients. (PubMed, PeerJ)
Our results expand the germline mutation spectrum in malignant GGO nodules. Importantly, these findings will potentially help screen the high-risk population, guide their health management, and contribute to their clinical treatment and determination of prognosis.
Clinical • Journal
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NOTCH3 (Notch Receptor 3) • RAD50 (RAD50 Double Strand Break Repair Protein) • LMO2 (LIM Domain Only 2) • CACNA1A (Calcium Voltage-Gated Channel Subunit Alpha1 A)
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RAD50 mutation
over3years
MEK inhibition overcomes resistance to EphA2-targeted therapy in uterine cancer. (PubMed, Gynecol Oncol)
These findings indicate that the MAPK pathway is activated in dasatinib-resistant uterine cancer cells and that EphrinA1-mediated MEK inhibition overcomes dasatinib resistance. Dual targeting of both EphA2 and MEK, combined with chemotherapy, should be considered for future clinical development.
Journal
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BRAF (B-raf proto-oncogene) • MYC (V-myc avian myelocytomatosis viral oncogene homolog) • NOTCH1 (Notch 1) • NOTCH3 (Notch Receptor 3) • HES1 (Hes Family BHLH Transcription Factor 1)
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MYC expression • NOTCH1 expression • NOTCH3 expression
|
Mekinist (trametinib) • dasatinib • carboplatin • paclitaxel
over3years
mRNA expression level of CDH2, LEP, POSTN, TIMP1 and VEGFC modulates 5-fluorouracil resistance in colon cancer cells. (PubMed, Exp Ther Med)
Silencing of these 5 genes using small interfering RNAs significantly enhanced the sensitivity of colon cancer cells to the chemotherapeutic agent, 5-fluorouracil (5-FU). Taken together, the results suggested that CDH2, LEP, POSTN, TIMP1 and VEGFC might play a role in chemotherapeutic resistance in colon cancer and represent potential targets for overcoming 5-FU resistance in colon cancer.
Journal
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ATM (ATM serine/threonine kinase) • CDKN2A (Cyclin Dependent Kinase Inhibitor 2A) • BCL6 (B-cell CLL/lymphoma 6) • NOTCH3 (Notch Receptor 3) • TIMP1 (Tissue inhibitor of metalloproteinases 1) • VEGFC (Vascular Endothelial Growth Factor C) • TGFB1 (Transforming Growth Factor Beta 1) • CDH2 (Cadherin 2) • XPA (XPA, DNA Damage Recognition And Repair Factor)
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KIM1 expression
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5-fluorouracil
over3years
[VIRTUAL] Correlation of Alterations in the KEAP1/CUL3/NFE2L2 Pathway with Radiation Failure in Laryngeal Squamous Cell Carcinoma (AHNS 2021)
Alterations in the KEAP1/CUL3/NRF2 pathway were associated with radiation resistance. Increased TMB may also be associated with response to RT. Further validation in a larger population is warranted.
Tumor Mutational Burden • IO biomarker
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KRAS (KRAS proto-oncogene GTPase) • TMB (Tumor Mutational Burden) • NRAS (Neuroblastoma RAS viral oncogene homolog) • BCL2 (B-cell CLL/lymphoma 2) • HRAS (Harvey rat sarcoma viral oncogene homolog) • NOTCH2 (Notch 2) • BIRC5 (Baculoviral IAP repeat containing 5) • NOTCH3 (Notch Receptor 3)
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KEAP1 mutation
over3years
Cancer-Associated Fibroblast-Derived Interleukin-8 Promotes Ovarian Cancer Cell Stemness and Malignancy Through the Notch3-Mediated Signaling. (PubMed, Front Cell Dev Biol)
Here, we show that IL-8 secreted from CAFs could activate normal ovarian fibroblasts (NFs) through multiple signaling and that IL-8 stimulated malignant growth of ovarian cancer cells in animals and increased the IC of cisplatin (CDDP) in ovarian cancer cells. Further study showed that IL-8 induced cancer cell stemness via the activation of Notch3 and that the high level of IL-8 in ascites was positively correlated with the expression of Notch3 in ovarian cancer tissues. Collectively, IL-8 secreted from CAFs and cancer cells promotes stemness in human ovarian cancer via the activation of the Notch3-mediated signaling, which may provide a novel strategy for ovarian cancer treatment.
Journal
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CXCL8 (Chemokine (C-X-C motif) ligand 8) • NOTCH3 (Notch Receptor 3)
|
CXCL8 expression • CXCL8 overexpression • NOTCH3 expression
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cisplatin
over3years
NOTCH Single Nucleotide Polymorphisms in the Predisposition of Breast and Colorectal Cancers in Saudi Patients. (PubMed, Pathol Oncol Res)
Interestingly, the rs1043994 located in NOTCH3 showed gender preference and was found to be significantly associated with colorectal cancers in males. Validation of these findings in bigger populations of different ethnicities may prove beneficial in identifying rs11249433 and rs1043994 as genetic screening markers for early detection of breast and colorectal carcinomas, respectively.
Clinical • Journal
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NOTCH1 (Notch 1) • NOTCH2 (Notch 2) • NOTCH3 (Notch Receptor 3) • NOTCH4 (Notch 4)