1. Functional activation of the AKT-mTOR signalling axis in a real-world metastatic breast cancer cohort.
- Author
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Prasad, Deepika, Baldelli, Elisa, Blais, Edik M., Davis, Justin, El Gazzah, Emna, Mueller, Claudius, Gomeiz, Alison, Ibrahim, Aisha, Newrekar, Avani Vinayak, Corgiat, Brian A., Dunetz, Rick, Petricoin III, Emanuel F., Wei, Qi, and Pierobon, Mariaelena
- Abstract
Background: Mutations of the PIK3CA/AKT/mTOR axis are common events in metastatic breast cancers (MBCs). This study was designed to evaluate the extent to which genetic alterations of the PIK3CA/AKT/mTOR can predict protein activation of this signalling axis in MBCs. Methods: Molecular profiles were generated by CLIA-certified laboratories from a real-world evidence cohort of 171 MBC patients. Genetic alterations of the PIK3CA pathway were measured using next-generation sequencing. Activation levels of AKT and downstream signalling molecules were quantified using two orthogonal proteomic methods. Protein activity was correlated with underlying genomic profiles and response to CDK4/6 inhibition in combination with endocrine treatment (ET). Results: Oncogenic alterations of the PIK3CA/AKT/PTEN pathway were identified in 49.7% of cases. Genomic profiles emerged as poor predictors of protein activity (AUC:0.69), and AKT phosphorylation levels mimicked those of mutant lesions in 76.9% of wild-type tumours. High phosphorylation levels of the PI3K/AKT/mTOR downstream target p70S6 Kinase (T389) were associated with shorter PFS in patients treated with CDK4/6 inhibitors in combination with ET (HR:4.18 95%CI:1.19–14.63); this association was not seen when patients were classified by mutational status. Conclusions: Phosphoprotein-based measurements of drug targets and downstream substrates should be captured along with genomic information to identify MBCs driven by the PI3K/AKT/mTOR signalling. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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