Systematic review on CUL5's role in cancer cell therapies and modulation strategies

As the core scaffold protein of the Cullin-RING ligase 5 (CRL5) complex, CUL5 regulates the stability of multiple substrate proteins through the ubiquitin-proteasome system (UPS), playing a crucial role in the initiation, progression, and cellular therapy of malignant tumors. This review systematically elaborates the context-dependent role, molecular regulatory network, and therapeutic targeting potential of CUL5-mediated ubiquitination in cancer cell therapy. The activity of CUL5 is highly dependent on NEDD8-mediated neddylation, and its dysregulation indirectly influences tumor cell proliferation, apoptosis, metabolic reprogramming, angiogenesis, and the immune microenvironment by modulating key signaling pathways such as NOXA, mTORC, TRAF6/NF-κB, and JAK/STAT. Notably, CUL5 exhibits dual regulatory functions in various cancers, and its expression level correlates differently with prognosis depending on tumor type. In recent years, the development of inhibitors and nano-delivery systems targeting CUL5 and its related pathways has provided novel strategies for precisely targeting CUL5. Moreover, in adoptive cell therapies (e.g., CAR-T, TCR-T, CAR-NK), modulation of CUL5 expression can significantly enhance immune-cell proliferation, cytokine secretion, and anti-tumor efficacy. This article summarizes the multidimensional role of CUL5 in tumor cell therapy and prospects its potential as a novel therapeutic target in combined therapies and precision medicine.