Survivin Signaling in Clinical Oncology: A Multifaceted Dragon

Survivin is an inhibitor of apoptosis protein (IAP) family member preferentially expressed in a myriad of clinical cancers. The complex functional mechanism and regulatory roles of survivin in cell division and cell death has hindered current therapeutic regimes from decoding its diagnostic, prognostic, and therapeutic significance in the area of translational oncology. Pharmacological modulation of survivin was tagged with its evolving functional complexity associated with various cell-signaling cascades including PI3K/AKT, mammalian target of rapamycin (mTOR), extracellular signal-regulated kinases (ERK), mitogen-activated protein kinases (MAPK), signal transducer and activator of transcription (STAT), hypoxia-inducible factor-1 (HIF-1), heat-shock protein 90 (HSP90), p53, B-cell lymphoma 2 (Bcl2), epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF) etc. The present review provides a multifaceted role of survivin and its mechanistic action in an array of clinical cancers. Furthermore, the utilization of novel nanotechnology-based drug delivery systems for target-specific hurling of tumors enabling contemporaneous detection, treatment, and therapeutic imaging in cancer therapy are discussed.