Pharmacological modulation of autophagy: therapeutic potential and persisting obstacles

Dysregulated autophagy is associated with a variety of conditions, including cancer, neurodegenerative diseases, cardiovascular disorders and infectious diseases. However, despite significant efforts, no specific modulators of autophagy have yet been moved into the clinic. Here, Galluzziet al. discuss the therapeutic potential of autophagy modulators and consider the key challenges that have limited their development. Autophagy is central to the maintenance of organismal homeostasis in both physiological and pathological situations. Accordingly, alterations in autophagy have been linked to clinically relevant conditions as diverse as cancer, neurodegeneration and cardiac disorders. Throughout the past decade, autophagy has attracted considerable attention as a target for the development of novel therapeutics. However, such efforts have not yet generated clinically viable interventions. In this Review, we discuss the therapeutic potential of autophagy modulators, analyse the obstacles that have limited their development and propose strategies that may unlock the full therapeutic potential of autophagy modulation in the clinic.