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Efficient Everolimus Treatment for Metastatic Castration Resistant Prostate Cancer with AKT1 Mutation: A Case Report
Zhe Yu1, Wei Wei1, Hongruo Liu1
1Department of Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Abstract:
Metastatic castration resistant prostate cancer (mCRPC), the advanced stage of prostate cancer (PCa), develops resistance to first line androgen deprivation therapy (ADT). Aberrant androgen receptor (AR) and PI3K-Akt-mTOR signaling pathway are responsible for the development and progression of mCRPC. We herein describe a case of a 64-year-old male mCRPC patient with somatic AKT1 and AR mutations. The patient, who had been heavily pretreated by ADT and AR inhibitors, showed stable disease progression when he received everolimus, an mTOR inhibitor. The PSA level dropped drastically from 1493.0 ng/mL to 237.6 ng/mL, after 3 months of treatment. The overall survival (OS) was 43 months, of which the progression-free survival (PFS) with everolimus treatment was 7 months. The administration of mTOR inhibitor, everolimus, could achieve good clinical responses along with prolonging PFS for mCRPC patients harboring AKT1 mutations. Technology in precision medicine, such as targeted next-generation sequencing (NGS) of cancer-relevant genes, has promising function in personalized therapy.
Insights
Metastatic castration-resistant prostate cancer (mCRPC) patients with AKT1 mutations may benefit from everolimus, an mTOR inhibitor. This targeted therapy demonstrated significant PSA reduction and prolonged progression-free survival in a case study.
Area of Science:
- Oncology
- Molecular Biology
- Precision Medicine
Background:
- Metastatic castration-resistant prostate cancer (mCRPC) is an advanced stage of prostate cancer (PCa) characterized by resistance to androgen deprivation therapy (ADT).
- Aberrant androgen receptor (AR) signaling and the PI3K-Akt-mTOR pathway are implicated in mCRPC development and progression.
Observation:
- A case study of a 64-year-old male mCRPC patient with concurrent somatic AKT1 and AR mutations was analyzed.
- The patient had received extensive prior treatment including ADT and AR inhibitors.
Findings:
- Treatment with everolimus, an mTOR inhibitor, resulted in a significant PSA level reduction from 1493.0 ng/mL to 237.6 ng/mL within 3 months.
- The patient achieved a progression-free survival (PFS) of 7 months with everolimus, contributing to an overall survival (OS) of 43 months.
- This suggests that mTOR inhibition can yield clinical responses in mCRPC patients with AKT1 mutations.
Implications:
- Everolimus demonstrates potential as a therapeutic option for mCRPC patients with AKT1 mutations, improving clinical outcomes.
- Targeted next-generation sequencing (NGS) plays a crucial role in identifying actionable mutations for personalized prostate cancer therapy.
- Precision medicine approaches, guided by genetic profiling, offer promising avenues for managing advanced prostate cancer.
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