Programming cancer cells for high expression levels of Mcl1

The Bcl2 pro‐survival protein family has long been recognized for its important contributions to cancer. At elevated levels relative to pro‐apoptotic effector members, the survival proteins prevent cancer cells from initiating apoptosis in the face of many intrinsic tumour‐suppressing pathways and extrinsic therapeutic treatments aimed at controlling tumorigenesis. Recent studies, including genome‐wide analyses, have begun to focus attention on a particularly enigmatic member of the family—myeloid cell leukaemia 1 (Mcl1). For reasons that are not clear, Mcl1 in cancer cells is turned over rapidly, eliminated primarily through the ubiquitin–proteasome pathway. Moreover, the mechanistic aspects of this constitutive membrane‐associated protein have not been fully elucidated. As the pro‐cancer activity of Mcl1 requires elevated expression levels of the protein, the cancer genome adapts to ensure either high levels of synthesis or evasion of degradation, or both. Here, we focus on the complex strategies at play and their therapeutic implications.