Apoptosis-Based Therapeutics and Inhibitors in Clinical Trials or the Preclinical State

Apoptosis is a progressive cell death process that significantly preserves the homeostatic balance between cell division and death. It is an essential process that helps regenerate cells and tissues for eukaryotic development. Moreover, it inhibits unfavorable immunological reactions and is essential for phagocytosis-mediated cell removal. The apoptosis signaling pathway is driven by various interactions between multiple protein families, including caspases, B-cell lymphoma 2 (BCL-2), and other proteases, granzyme, and perforins. This pathway consists of prosurvival and proapoptotic members working together to stabilize the choice between cellular survival and death. However, this can turn into abnormal cell proliferation, which ultimately leads to cancer. Traditional chemotherapy and radiation therapy are beneficial for the treatment of cancer. Cancer cells may withstand the death process through the antiapoptotic effect of the apoptosis protein inhibitors. Both intrinsic and extrinsic pathways are involved in the process of apoptosis caused by cellular stress and DNA damage. This review elaborates on the apoptotic signaling pathways, mechanisms, interacting members, and strategies that target these pathways.