Elsevier

Annals of Oncology

Volume 30, Issue 7, July 2019, Pages 1051-1060
Annals of Oncology

Reviews
Targeting the PI3-kinase pathway in triple-negative breast cancer

https://doi.org/10.1093/annonc/mdz133Get rights and content
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ABSTRACT

Triple-negative breast cancer (TNBC) is characterised by poor outcomes and a historical lack of targeted therapies. Dysregulation of signalling through the phosphoinositide 3 (PI3)-kinase and AKT signalling pathway is one of the most frequent oncogenic aberrations of TNBC. Although mutations in individual genes occur relatively rarely, combined activating mutations in PIK3CA and AKT1, with inactivating mutations in phosphatase and tensin homologue, occur in ∼25%‒30% of advanced TNBC. Recent randomised trials suggest improved progression-free survival (PFS) with AKT-inhibitors in combination with first-line chemotherapy for patients with TNBC and pathway genetic aberrations. We review the evidence for PI3K pathway activation in TNBC, and clinical trial data for PI3K, AKT and mammalian target of rapamycin inhibitors in TNBC. We discuss uncertainty over defining which cancers have pathway activation and the future overlap between immunotherapy and pathway targeting.

Key words

triple-negative breast cancer
PI3K
AKT
PTEN
targeted therapy
predictive biomarkers

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