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AKT as a Therapeutic Target in Cancer
1Institute of Pharmaceutical Science, King's College London, London, UK.
Abstract:
Aberrant activation of the PI3K pathway is one of the commonest oncogenic events in human cancer. AKT is a key mediator of PI3K oncogenic function, and as such, it has been intensively pursued as a therapeutic target. Despite the high frequency of AKT activation in human tumors, the clinical performance of AKT inhibitors remained largely disappointing for many years. However, the recent approval of the AKT inhibitor capivasertib (formerly AZD-5363) for the treatment of breast cancer provides clinical validation of its therapeutic relevance and raises the possibility that AKT inhibitors could still provide clinical benefit either as monotherapy in patients with the rare AKT-E17K mutation or in broader patient populations when combined with other agents. In this chapter, we review the evidence for AKT dependence in human tumors, the importance of genetic and cellular context in AKT dependence, and the challenges of translating AKT inhibition into therapeutic benefit.
Insights
Aberrant activation of the PI3K/AKT pathway is common in cancer. While AKT inhibitors like capivasertib show promise, especially for specific mutations or combination therapies, challenges remain in translating this to broad clinical benefit.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Aberrant activation of the Phosphatidylinositol 3-Kinase (PI3K) pathway is a frequent oncogenic event in human cancers.
- AKT, a crucial mediator of PI3K's oncogenic function, has been a significant therapeutic target.
- Despite frequent AKT activation, clinical outcomes with AKT inhibitors were historically disappointing.
Purpose of the Study:
- To review the evidence supporting AKT dependence in human tumors.
- To discuss the influence of genetic and cellular context on AKT dependence.
- To explore challenges in translating AKT inhibition into effective cancer therapies.
Main Methods:
- Literature review of studies on PI3K/AKT pathway activation in cancer.
- Analysis of clinical trial data for AKT inhibitors.
- Examination of preclinical models investigating AKT dependence.
Main Results:
- The approval of capivasertib for breast cancer validates AKT inhibitors' therapeutic potential.
- AKT inhibitors may offer benefit as monotherapy in rare AKT-E17K mutations.
- Combination therapies hold promise for broader patient populations.
Conclusions:
- AKT remains a relevant therapeutic target, with recent approvals highlighting its potential.
- Understanding tumor context is critical for effective AKT-targeted therapy.
- Overcoming challenges in AKT inhibition translation is key for future clinical success.
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