Cited by 504PI3K/AKT/mTOR signaling in cancerAdvanced Breast Cancer TherapiesProtein Kinase Regulation and GTPase Signaling

Overcoming mTOR resistance mutations with a new-generation mTOR inhibitor

Open access
Rodrik-Outmezguine, Vanessa S., Okaniwa, Masanori, Yao, Zhan, Novotny, Chris J., McWhirter, Claire, Banaji, Arpitha, Won, Helen, Wong, Wai +7 more·2016·Nature

Abstract

Precision medicines exert selective pressure on tumour cells that leads to the preferential growth of resistant subpopulations, necessitating the development of next-generation therapies to treat the evolving cancer. The PIK3CA-AKT-mTOR pathway is one of the most commonly activated pathways in human cancers, which has led to the development of small-molecule inhibitors that target various nodes in the pathway. Among these agents, first-generation mTOR inhibitors (rapalogs) have caused responses in 'N-of-1' cases, and second-generation mTOR kinase inhibitors (TORKi) are currently in clinical trials. Here we sought to delineate the likely resistance mechanisms to existing mTOR inhibitors in human cell lines, as a guide for next-generation therapies. The mechanism of resistance to the TORKi was unusual in that intrinsic kinase activity of mTOR was increased, rather than a direct active-site mutation interfering with drug binding. Indeed, identical drug-resistant mutations have been also identified in drug-naive patients, suggesting that tumours with activating MTOR mutations will be intrinsically resistant to second-generation mTOR inhibitors. We report the development of a new class of mTOR inhibitors that overcomes resistance to existing first- and second-generation inhibitors. The third-generation mTOR inhibitor exploits the unique juxtaposition of two drug-binding pockets to create a bivalent interaction that allows inhibition of these resistant mutants.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1038/nature17963

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Rodrik-Outmezguine, V. S., Okaniwa, M., Yao, Z., Novotny, C. J., McWhirter, C., Banaji, A., Won, H., Wong, W., Berger, M., de Stanchina, E., Barratt, D. G., Cosulich, S., Klinowska, T., Rosen, N., & Shokat, K. M.
Affiliations
  • Memorial Sloan Kettering Cancer Center (US)
  • Howard Hughes Medical Institute (US)
  • AstraZeneca (United Kingdom) (GB)
Corresponding author
  • Rosen, Neal
  • Shokat, Kevan M.
Venue
Nature
Published
2016-05-18
Volume
534
Issue
7606
Pages
272-276
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W2407198816
Cited by
479
References
28
Citations by year
2026: 28 · 2025: 48 · 2024: 41 · 2023: 56 · 2022: 51 · 2021: 63 · 2020: 49 · 2019: 34 · 2018: 47 · 2017: 44 · 2016: 16
FWCI
24.42
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Howard Hughes Medical Institute
  • National Institute on Alcohol Abuse and Alcoholism (P50AA017072)
  • National Cancer Institute (P01CA129243, P01CA094060, P30CA008748)
  • National Institute of General Medical Sciences (T32GM064337)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › PI3K/AKT/mTOR signaling in cancer
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Advanced Breast Cancer Therapies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Protein Kinase Regulation and GTPase Signaling
Keywords
mTOR kinase, drug resistance, mTOR inhibitors, kinase domain mutations, rapalogs, cancer therapy resistance, tumor growth inhibition
MeSH terms
Animals, Binding Sites, Drug Resistance, Female, Humans, Mutation, Neoplasms, Signal Transduction, Protein Structure, Tertiary, Xenograft Model Antitumor Assays, Cell Line, Tumor, Protein Kinase Inhibitors, Mice, TOR Serine-Threonine Kinases

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review