Targeting Apoptotic Pathways in Cancer Cells: Integrating Oncology Nursing with Cellular Mechanisms for Personalized Cancer Therapies

Abstract

Background: Apoptosis-targeting therapies have emerged as a promising strategy in cancer treatment by selectively inducing programmed cell death in malignant cells. This study evaluates the effectiveness of BH3 mimetics, death receptor agonists, and caspase activators in promoting apoptosis, modulating key biomarkers, and improving clinical outcomes. Additionally, it examines the role of oncology nurses in optimizing patient adherence, managing adverse events, and integrating biomarker-based treatment strategies. Methods: A multi-faceted research design incorporating in vitro, in vivo, and clinical observational studies was employed. Cancer cell lines were treated with apoptosis-inducing agents, and apoptosis rates were measured using Annexin V/PI staining assays. Western blot and qRT-PCR quantified apoptotic biomarker expression, while Kaplan-Meier survival analysis assessed overall survival (OS) and progression-free survival (PFS) in patients receiving apoptosis-targeting therapies. Qualitative interviews and focus group discussions with oncology nurses explored the impact of patient education and adherence strategies. Results: Caspase activators demonstrated the highest apoptotic induction (up to 75%), upregulating Bax (2.4-fold), Caspase-3 (2.6-fold), and p53 (2.3-fold) while downregulating Bcl-2 (0.4-fold). Patients treated with caspase activators had the longest OS (22 months), compared to BH3 mimetics (20 months) and death receptor agonists (18 months). However, apoptotic resistance was observed, with resistant cells exhibiting increased Bcl-2 expression and decreased Bax and Caspase-3 levels. Conclusion: Apoptosis-targeting therapies enhance cancer cell death and prolong survival, but resistance mechanisms necessitate combination strategies and biomarker-guided treatment selection. Oncology nurses play a crucial role in treatment adherence and toxicity management, underscoring the need for integrated, personalized approaches in precision oncology.