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Yu L, Wei J, Liu P. Attacking the PI3K/Akt/mTOR signaling pathway for targeted therapeutic treatment in human cancer. Semin Cancer Biol 2021; 85:69-94. [PMID: 34175443 DOI: 10.1016/j.semcancer.2021.06.019] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 02/08/2023]
Abstract
Cancer is the second leading cause of human death globally. PI3K/Akt/mTOR signaling is one of the most frequently dysregulated signaling pathways observed in cancer patients that plays crucial roles in promoting tumor initiation, progression and therapy responses. This is largely due to that PI3K/Akt/mTOR signaling is indispensable for many cellular biological processes, including cell growth, metastasis, survival, metabolism, and others. As such, small molecule inhibitors targeting major kinase components of the PI3K/Akt/mTOR signaling pathway have drawn extensive attention and been developed and evaluated in preclinical models and clinical trials. Targeting a single kinase component within this signaling usually causes growth arrest rather than apoptosis associated with toxicity-induced adverse effects in patients. Combination therapies including PI3K/Akt/mTOR inhibitors show improved patient response and clinical outcome, albeit developed resistance has been reported. In this review, we focus on revealing the mechanisms leading to the hyperactivation of PI3K/Akt/mTOR signaling in cancer and summarizing efforts for developing PI3K/Akt/mTOR inhibitors as either mono-therapy or combination therapy in different cancer settings. We hope that this review will facilitate further understanding of the regulatory mechanisms governing dysregulation of PI3K/Akt/mTOR oncogenic signaling in cancer and provide insights into possible future directions for targeted therapeutic regimen for cancer treatment, by developing new agents, drug delivery systems, or combination regimen to target the PI3K/Akt/mTOR signaling pathway. This information will also provide effective patient stratification strategy to improve the patient response and clinical outcome for cancer patients with deregulated PI3K/Akt/mTOR signaling.
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Affiliation(s)
- Le Yu
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Biochemistry and Biophysics, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | | | - Pengda Liu
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Biochemistry and Biophysics, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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Leroux C, Konstantinidou G. Targeted Therapies for Pancreatic Cancer: Overview of Current Treatments and New Opportunities for Personalized Oncology. Cancers (Basel) 2021; 13:799. [PMID: 33672917 DOI: 10.3390/cancers13040799] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 02/06/2023] Open
Abstract
Cytotoxic chemotherapy remains the only treatment option for most pancreatic ductal adenocarcinoma patients. Currently, the median overall survival of patients with advanced disease rarely exceeds 1 year. The complex network of pancreatic cancer composed of immune cells, endothelial cells, and cancer-associated fibroblasts confers intratumoral and intertumoral heterogeneity with distinct proliferative and metastatic propensity. This heterogeneity can explain why tumors do not behave uniformly and are able to escape therapy. The advance in technology of whole-genome sequencing has now provided the possibility of identifying every somatic mutation, copy-number change, and structural variant in a given cancer, giving rise to personalized targeted therapies. In this review, we provide an overview of the current and emerging treatment strategies in pancreatic cancer. By highlighting new paradigms in pancreatic ductal adenocarcinoma treatment, we hope to stimulate new thoughts for clinical trials aimed at improving patient outcomes.
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Hull A, Li Y, Bartholomeusz D, Hsieh W, Allen B, Bezak E. Radioimmunotherapy of Pancreatic Ductal Adenocarcinoma: A Review of the Current Status of Literature. Cancers (Basel) 2020; 12:E481. [PMID: 32092952 PMCID: PMC7072553 DOI: 10.3390/cancers12020481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/15/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) has long been associated with low survival rates. A lack of accurate diagnostic tests and limited treatment options contribute to the poor prognosis of PDAC. Radioimmunotherapy using α- or β-emitting radionuclides has been identified as a potential treatment for PDAC. By harnessing the cytotoxicity of α or β particles, radioimmunotherapy may overcome the anatomic and physiological factors which traditionally make PDAC resistant to most conventional treatments. Appropriate selection of target receptors and the development of selective and cytotoxic radioimmunoconjugates are needed to achieve the desired results of radioimmunotherapy. The aim of this review is to examine the growing preclinical and clinical trial evidence regarding the application of α and β radioimmunotherapy for the treatment of PDAC. A systematic search of MEDLINE® and Scopus databases was performed to identify 34 relevant studies conducted on α or β radioimmunotherapy of PDAC. Preclinical results demonstrated α and β radioimmunotherapy provided effective tumour control. Clinical studies were limited to investigating β radioimmunotherapy only. Phase I and II trials observed disease control rates of 11.2%-57.9%, with synergistic effects noted for combination therapies. Further developments and optimisation of treatment regimens are needed to improve the clinical relevance of α and β radioimmunotherapy in PDAC.
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Affiliation(s)
- Ashleigh Hull
- Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (Y.L.); (W.H.); (E.B.)
| | - Yanrui Li
- Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (Y.L.); (W.H.); (E.B.)
| | - Dylan Bartholomeusz
- Department of PET, Nuclear Medicine & Bone Densitometry, Royal Adelaide Hospital, SA Medical Imaging, Adelaide, SA 5000, Australia;
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - William Hsieh
- Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (Y.L.); (W.H.); (E.B.)
- Department of PET, Nuclear Medicine & Bone Densitometry, Royal Adelaide Hospital, SA Medical Imaging, Adelaide, SA 5000, Australia;
| | - Barry Allen
- Faculty of Medicine, Western Sydney University, Liverpool, NSW 2170, Australia;
| | - Eva Bezak
- Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (Y.L.); (W.H.); (E.B.)
- Department of Physics, The University of Adelaide, Adelaide, SA 5000, Australia
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Liu X, Xie C, Li A, Zhang Y, Liu X, Zhou S, Shen J, Huo Z, Cao W, Ma Y, Xu R, Xing Y, Xie Y, Cai S, Tang X. BEZ235 enhances chemosensitivity of paclitaxel in hepatocellular carcinoma through inhibiting the PI3K/Akt/mTOR pathway. Am J Transl Res 2019; 11:7255-7271. [PMID: 31934276 PMCID: PMC6943462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
Desensitization of hepatocellular carcinoma (HCC) to paclitaxel chemotherapy is a major deterrent to successful treatment of the cancer. Abnormal activation of the PI3K/Akt/mTOR, pathway is a common outcome of chemotherapy for HCC. Therefore, we investigated whether BEZ235, a dual PI3K and mTOR inhibitor, could increase the sensitivity of HCC to paclitaxel. In vitro results showed that paclitaxel, combined with BEZ235, inhibited HCC cell proliferation and migration, arrested the cell cycle in the G2/M phase, and promoted cell apoptosis by decreasing PI3K/Akt/mTOR activity. In vivo experiments confirmed that BEZ235 enhances the anti-tumor effect of paclitaxel by reducing PI3K/Akt/mTOR activity. Immunohistochemical staining showed that paclitaxel combined with BEZ235 reduced the numbers of Ki-67- and GPC3-positive HepG2 cells in tumor tissues. We conclude that BEZ235 enhanced the sensitivity of HCC to paclitaxel, and inhibition of PI3K/Akt/mTOR signaling might be a therapeutic strategy against paclitaxel-resistant HCC.
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Affiliation(s)
- Xueke Liu
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Chunmei Xie
- Department of Blood Transfusion, Guangzhou 8th People’s Hospital, Guangzhou Medical UniversityGuangzhou 510100, China
| | - Amin Li
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Yinci Zhang
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Xinkuang Liu
- First Affiliated Hospital of Medical College, Anhui University of Science and TechnologyHuainan 232001, China
| | - Shuping Zhou
- First Affiliated Hospital of Medical College, Anhui University of Science and TechnologyHuainan 232001, China
| | - Jing Shen
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Zhen Huo
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Weiya Cao
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Yongfang Ma
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Ruyue Xu
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Yingru Xing
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Yinghai Xie
- First Affiliated Hospital of Medical College, Anhui University of Science and TechnologyHuainan 232001, China
| | - Shuyu Cai
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
| | - Xiaolong Tang
- Key Laboratory of Industrial Dust Prevention and Control and Occupational Safety and Health of The Ministry of Education, Anhui University of Science and TechnologyHuainan 232001, China
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