Carcinogenesis is a complex multi-step process involving metabolic and behavioral changes enabling transformed cells to survive and adapt to the tumor microenvironment [
66]. Most cancers are associated with various genetic and epigenetic changes leading to the malfunctioning of critical genes, including the
TP53 gene. However, cancer cells also depend on the normal functioning of certain genes. As such, activation of specific cytoprotective mechanisms, such as HSR, can support the survival of transformed cells. It has been found that HSF1 normally regulates a subset of genes involved in controlling cell proliferation and cell cycle progression [
67,
68]. The requirement of HSF1 also extends to the survival of transformed cells. Consequently, cancer cells may become addicted to HSF1. Although HSF1 is neither a tumor suppressor nor a typical oncogene, it affects many aspects of cellular metabolism that are important for the cancer phenotype, i.e., it modulates signaling pathways associated with growth and proliferation, apoptosis, glucose metabolism, angiogenesis and cell motility [
4]. Additionally, its activity has been found to modulate signaling pathways that are altered through the expression of mutant oncogenic proteins, thus affecting the phenotype of cancer cells. This phenomenon has been referred to as “non-oncogenic addiction” [
69]. HSF1 has been shown to promote oncogenesis driven for example by mutant p53 (or the loss of 53), mutant RAS, PDGFB (platelet derived growth factor subunit B), ERBB2 (erb-b2 receptor tyrosine kinase 2, also called HER2 or HER2/neu), loss of the tumor suppressor NF1 (neurofibromatosis type 1), and chemical carcinogens [
4]. Genome-wide analyses indicate that the activity of HSF1 in cancer cells is strongly associated with metastasis and a poor survival in at least three types of cancer, breast, colon and lung, responsible for ~30% of all cancer-related deaths worldwide [
70].
The development of a wide range of cancers (>50%) is associated with mutations in the
TP53 gene. To date, mutations have been identified in over 200 different amino acid positions of the p53 protein. Such mutations impair p53 protein function, which can lead to (i)
“loss-of-function”, associated with missense mutations that can escalate genomic instability, metastasis, resistance to chemotherapy and radiotherapy, tumor progression and a poor survival, (ii)
dominant negative activity of mutant p53, which leads to loss of p53 tumor suppressive activity, but the acquisition of dominant negative activity on the remaining wild-type p53 protein, and is associated with accelerated tumor development, (iii) “
gain-of-function”, which confers oncogenic properties on p53 leading to aggressive tumor growth [
20]. Additionally, in those cancers that retain wild-type p53, its activity can be attenuated by several mechanisms, i.e., wild-type p53 can be inactivated by proteins encoded by DNA tumor viruses [
71], by down-regulation of p53 cooperators such as ARF, or by overexpression of p53 inhibitors such as MDM2 and its homolog MDM4 (p53 regulator). ARF (also called p14ARF, resulting from an alternative reading frame in the
CDKN2A locus, which is frequently mutated or deleted in a wide range of tumors) is a tumor suppressor and a key activator of the p53 pathway in response to oncogene activation (e.g. E2F1, MYC, RAS, E1A) [
72], whereas MDM2, classified as an oncogene, is amplified in nearly 8% (and MDM4 in ~10–20%, but up to 65% in retinoblastoma) of human cancers with wild-type p53, such as lung, colon, stomach, or breast cancers [
73].