Strategies for co-targeting the PI3K/AKT/mTOR pathway in NSCLC.
The PI3K/AKT/mTOR pathway regulates cell growth and proliferation and is often dysregulated in cancer due to mutation, amplification, deletion, methylation and post-translational modifications. We and others have shown that activation of this pathway in non-small cell lung cancer (NSCLC) leads to a more aggressive disease which correlates to poor prognosis for patients. A multitude of selective inhibitors are in development which target key regulators in this pathway, however the success of PI3K targeted inhibition has been hampered by a high rate of innate and acquired resistance. Response to PI3K inhibition may be improved by co-targeting potential mediators of resistance, such as related cell surface receptors or other intracellular signaling pathways which cross-talk with the PI3K pathway. Inhibition of the PI3K pathway may also overcome radioresistance, chemoresistance and immune evasion in NSCLC. The identification of appropriate patient cohorts who will benefit from PI3K co-targeted inhibition strategies will be key to the success of these inhibitors.
Thoracic Oncology Research, Institute of Molecular Medicine, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland. Electronic address: heaveys@tcd.ie.
Susan
S
Heavey
Thoracic Oncology Research, Institute of Molecular Medicine, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland.
Kenneth J
KJ
O'Byrne
Thoracic Oncology Research, Institute of Molecular Medicine, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland.
Kathy
K
Gately
D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D009154:Mutation; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics* / Q000378:metabolism; D015398:Signal Transduction; D058570:TOR Serine-Threonine Kinases / Q000235:genetics* / Q000378:metabolism
D004273:DNA, Neoplasm; D019869:Phosphatidylinositol 3-Kinases; D058570:TOR Serine-Threonine Kinases; C546842:MTOR protein, human
Chemoresistance; Co-targeted inhibition; Lung cancer; MEK; NSCLC; PI3K; PI3K inhibition; PIK3CA; Radioresistance; mTOR