Assessing PIK3CA and PTEN in early-phase trials with PI3K/AKT/mTOR inhibitors.

Assessing PIK3CA and PTEN in early-phase trials with PI3K/AKT/mTOR inhibitors.
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DOI:
10.1016/j.celrep.2013.12.035
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发表时间:
2014-01-30
期刊:
影响因子:
8.8
通讯作者:
Kurzrock R
Kurzrock R
中科院分区:
生物学1区
文献类型:
--
作者:
Janku F;Hong DS;Fu S;Piha-Paul SA;Naing A;Falchook GS;Tsimberidou AM;Stepanek VM;Moulder SL;Lee JJ;Luthra R;Zinner RG;Broaddus RR;Wheler JJ;Kurzrock R

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尽管进行了大量的临床前研究,但尚不清楚PIK 3CA或PTEN基因畸变在临床环境中是否可行。在1,656例晚期难治性癌症患者中,检测PIK 3CA或PTEN异常,PIK 3CA突变率为9%(146/1,589),PTEN缺失和/或突变率为13%(149/1,157)。在多协变量分析中,PI 3 K/AKT/mTOR抑制剂治疗是预测携带PIK 3CA或PTEN畸变个体对治疗反应的唯一独立因素。在H1047 R PIK 3CA突变个体亚组中,疾病稳定(SD)≥6个月/部分缓解率达到45%。PI 3 K/AKT/mTOR通路的异常在患有多种晚期癌症的患者中是常见的并且可能是可操作的。这项工作提供了进一步的重要临床验证的持续和加速使用生物标志物驱动的试验纳入合理的药物组合。
Despite a wealth of preclinical studies, it is unclear whether PIK3CA or PTEN gene aberrations are actionable in the clinical setting. Of 1,656 patients with advanced, refractory cancers tested for PIK3CA or PTEN abnormalities, PIK3CA mutations were found in 9% (146/1,589), and PTEN loss and/or mutation in 13% (149/1,157). In multicovariable analysis, treatment with a PI3K/AKT/mTOR inhibitor was the only independent factor predicting response to therapy in individuals harboring a PIK3CA or PTEN aberration. The rate of stable disease (SD) ≥6 months/partial response reached 45% in a subgroup of individuals with H1047R PIK3CA mutations. Aberrations in the PI3K/AKT/mTOR pathway are common and potentially actionable in patients with diverse advanced cancers. This work provides further important clinical validation for continued and accelerated use of biomarker-driven trials incorporating rational drug combinations.
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