Functional Mapping of AKT Signaling and Biomarkers of Response from the FAIRLANE Trial of Neoadjuvant Ipatasertib plus Paclitaxel for Triple-Negative Breast Cancer.
Por:
Shi Z, Wulfkuhle J, Nowicka M, Gallagher R, Saura C, Nuciforo P, Calvo I, Andersen J, Passos-Coelho J, Gil-Gil M, Bermejo B, Pratt D, Ciruelos E, Villagrasa P, Wongchenko M, Petricoin E, Oliveira M, Isakoff S
Publicada:
1 mar 2022
Resumen:
PURPOSE: Despite extensive genomic and transcriptomic profiling, it remains unknown how signaling pathways are differentially activated and how tumors are differentially sensitized to certain perturbations. Here, we aim to characterize AKT signaling activity and its association with other genomic or IHC-based PI3K/AKT pathway biomarkers as well as the clinical activity of ipatasertib (AKT inhibitor) in the FAIRLANE trial. EXPERIMENTAL DESIGN: In FAIRLANE, 151 patients with early triple-negative breast cancer (TNBC) were randomized 1:1 to receive paclitaxel with ipatasertib or placebo for 12 weeks prior to surgery. Adding ipatasertib did not increase pathologic complete response rate and numerically improved overall response rate by MRI. We used reverse-phase protein microarrays (RPPA) to examine the total level and/or phosphorylation states of over 100 proteins in various signaling or cell processes including PI3K/AKT and mTOR signaling. One hundred and twenty-five baseline and 127 on-treatment samples were evaluable by RPPA, with 110 paired samples at both time points. RESULTS: Tumors with genomic/protein alterations in PIK3CA/AKT1/PTEN were associated with higher levels of AKT phosphorylation. In addition, phosphorylated AKT (pAKT) levels exhibited a significant association with enriched clinical benefit of ipatasertib, and identified patients who received benefit in the absence of PIK3CA/AKT1/PTEN alterations. Ipatasertib treatment led to a downregulation of AKT/mTORC1 signaling, which was more pronounced among the tumors with PIK3CA/AKT1/PTEN alterations or among the responders to the treatment. CONCLUSIONS: We showed that the high baseline pAKT levels are associated with the alterations of PI3K/AKT pathway components and enriched benefit of ipatasertib in TNBC.
Filiaciones:
Shi Z:
Genentech Inc, Dept Oncol Biomarker, San Francisco, CA 94080 USA
Wulfkuhle J:
George Mason Univ, Ctr Appl Prote & Mol Med, Manassas, VA USA
Nowicka M:
F Hoffmann La Roche Ltd, Basel, Switzerland
Gallagher R:
George Mason Univ, Ctr Appl Prote & Mol Med, Manassas, VA USA
Saura C:
Vall dHebron Univ Hosp, Med Oncol Dept, Barcelona, Spain
Vall dHebron Inst Oncol VHIO, Breast Canc Grp, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
SOLTI Breast Canc Res Grp, Barcelona, Spain
Nuciforo P:
Vall dHebron Inst Oncol VHIO, Mol Oncol Grp, Barcelona, Spain
Calvo I:
Ctr Integral Oncol Clara Campal CIOCC, Breast Canc Unit, Madrid, Spain
Andersen J:
Compass Oncol, Med Oncol Hematol, Tigard, OR USA
Passos-Coelho J:
Hosp Beatriz Angelo, Oncol Dept, Loures, Portugal
Gil-Gil M:
SOLTI Breast Canc Res Grp, Barcelona, Spain
Inst Catala Oncol, Med Oncol Serv, Barcelona, Spain
Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain
Bermejo B:
Hosp Clin Univ Valencia, Valencia, Spain
Pratt D:
US Oncol, Texas Oncol Canc Ctr, Austin, TX USA
Ciruelos E:
SOLTI Breast Canc Res Grp, Barcelona, Spain
Univ Hosp 12 Octubre, Med Oncol Dept, Madrid, Spain
Villagrasa P:
SOLTI Breast Canc Res Grp, Barcelona, Spain
Wongchenko M:
Genentech Inc, Dept Oncol Biomarker, San Francisco, CA 94080 USA
Petricoin E:
George Mason Univ, Ctr Appl Prote & Mol Med, Manassas, VA USA
Oliveira M:
Vall dHebron Univ Hosp, Med Oncol Dept, Barcelona, Spain
Vall dHebron Inst Oncol VHIO, Breast Canc Grp, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
SOLTI Breast Canc Res Grp, Barcelona, Spain
Isakoff S:
Massachusetts Gen Hosp, Div Hematol Oncol, Ctr Canc, 55 Fruit St, Boston, MA 02114 USA
Green Submitted, Green Published, hybrid
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