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Deregulation of the EGFR/PI3K/PTEN/Akt/mTORC1 pathway in breast cancer: possibilities for therapeutic intervention
Authors:Nicole M. Davis  Melissa Sokolosky  Kristin Stadelman  Stephen L. Abrams  Massimo Libra  Saverio Candido  Ferdinando Nicoletti  Jerry Polesel  Roberta Maestro  Antonino D’Assoro  Lyudmyla Drobot  Dariusz Rakus  Agnieszka Gizak  Piotr Laidler  Joanna Dulińska-Litewka  Joerg Basecke  Sanja Mijatovic  Danijela Maksimovic-Ivanic  Giuseppe Montalto  Melchiorre Cervello  Timothy L. Fitzgerald  Zoya N. Demidenko  Alberto M. Martelli  Lucio Cocco  Linda S. Steelman  James A. McCubrey
Abstract:The EGFR/PI3K/PTEN/Akt/mTORC1/GSK-3 pathway plays prominent roles in malignant transformation, prevention of apoptosis, drug resistance and metastasis. The expression of this pathway is frequently altered in breast cancer due to mutations at or aberrant expression of: HER2, ERalpha, BRCA1, BRCA2, EGFR1, PIK3CA, PTEN, TP53, RB as well as other oncogenes and tumor suppressor genes. In some breast cancer cases, mutations at certain components of this pathway (e.g., PIK3CA) are associated with a better prognosis than breast cancers lacking these mutations. The expression of this pathway and upstream HER2 has been associated with breast cancer initiating cells (CICs) and in some cases resistance to treatment. The anti-diabetes drug metformin can suppress the growth of breast CICs and herceptin-resistant HER2+ cells. This review will discuss the importance of the EGFR/PI3K/PTEN/Akt/mTORC1/GSK-3 pathway primarily in breast cancer but will also include relevant examples from other cancer types. The targeting of this pathway will be discussed as well as clinical trials with novel small molecule inhibitors. The targeting of the hormone receptor, HER2 and EGFR1 in breast cancer will be reviewed in association with suppression of the EGFR/PI3K/PTEN/Akt/mTORC1/GSK-3 pathway.
Keywords:Targeted Therapy   Therapy Resistance   Mutations   PI3K   mTOR   rapamycin
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