PTEN, PIK3CA, p-AKT, and p-p70S6K Status
Open accessAbstract
Phosphatase and tensin homolog (PTEN) is a key modulator of trastuzumab sensitivity in HER2-overexpressing breast cancer. Because PTEN opposes the downstream signaling of phosphoinositide 3-kinase (PI3K), we investigated the role of PTEN and other components of the PI3K pathway in trastuzumab resistance. We analyzed the status of PTEN, p-AKT-Ser473, and p-p70S6K-Thr389 using immunohistochemistry. PIK3CA mutation status was analyzed by direct sequencing. Primary tumor tissue was available from 137 patients with HER2-overexpressing metastatic breast cancer who had received trastuzumab-based chemotherapy. We observed that each of the four biomarkers alone did not significantly correlate with trastuzumab response, whereas PTEN loss alone significantly correlated with shorter survival times (P = 0.023). PI3K pathway activation, defined as PTEN loss and/or PIK3CA mutation, was associated with a poor response to trastuzumab (P = 0.047) and a shorter survival time (P = 0.015). PTEN loss was significantly associated with a poor response to trastuzumab (P = 0.028) and shorter survival time (P = 0.008) in patients who had received first-line trastuzumab and in patients with estrogen receptor- (P = 0.029) and progesterone receptor-negative tumors (P = 0.033). p-AKT-Ser473 and p-p70S6K-Thr389 each had a limited correlation with trastuzumab response. When these markers were combined with PTEN loss, an increased correlation with patient outcome was observed. In conclusion, PI3K pathway activation plays a pivotal role in trastuzumab resistance. Our findings may facilitate the evaluation of tumor response to trastuzumab-based and targeted therapies.
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Patients with 'hot spot' PIK3CA mutations and undetectable or low PTEN measured by IHC exhibited a poorer outcome after treatment with chemotherapy and trastuzumab compared to patients without those alterations.
“Patients with ‘hot spot’ PIK3CA mutations and undetectable or low PTEN measured by IHC, exhibited a poorer outcome after treatment with chemotherapy and trastuzumab compared to patients without those alterations (Berns et al., 2007; Dave et al., 2011; Esteva et al., 2010).”
From ERBB Receptors: From Oncogene Discovery to Basic Science to Mechanism-Based Cancer Therapeutics (2014) · cites this paper as Esteva et al., 2010
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- Authors
- Esteva, F. J., Guo, H., Zhang, S., Santa-Maria, C., Stone, S., Lanchbury, J. S., Sahin, A. A., Hortobagyi, G. N., & Yu, D.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Myriad Genetics (US)
- Corresponding author
- Yu, Dihua
- ORCID
- Venue
- The American Journal of Pathology
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 177
- Issue
- 4
- Pages
- 1647-1656
- ISSN
- 0002-9440 (ISSN-L)
- PMC
- PMC2947262
- OpenAlex
- W155933052
- Cited by
- 285
- References
- 47
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 5 · 2020: 4 · 2019: 11 · 2018: 20 · 2017: 17 · 2016: 33 · 2015: 38 · 2014: 42 · 2013: 32 · 2012: 27
- FWCI
- 13.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal Of Pathology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Breast Cancer Research Foundation (RO1-CA112567)
- Susan G. Komen (KG091020)
- National Institutes of Health (P50 CA116199, P30-CA 16672)
- U.S. Department of Defense (W81XWH-08-1-0712)
- Topics
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › PI3K/AKT/mTOR signaling in cancer
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Keywords
- PTEN loss, PIK3CA mutation, PI3K pathway activation, trastuzumab resistance, HER2-positive breast cancer, metastatic breast cancer, Akt phosphorylation, p70S6K phosphorylation, trastuzumab response, survival, hormone receptor-negative tumors, predictive biomarkers
- MeSH terms
- Trastuzumab, Adult, Aged, Antibodies, Monoclonal, Bone Neoplasms, Brain Neoplasms, Breast Neoplasms, Female, Humans, Immunoenzyme Techniques, Liver Neoplasms, Lung Neoplasms, Lymphatic Metastasis, Middle Aged, Mutation, Neoplasm Invasiveness, Phosphorylation, Prognosis, Receptors, Estrogen, Receptors, Progesterone, Survival Rate, In Situ Hybridization, Carcinoma, Ductal, Breast, Carcinoma, Lobular, Receptor, ErbB-2, Erb-b2 Receptor Tyrosine Kinases, Phosphatidylinositol 3-Kinases, Ribosomal Protein S6 Kinases, 70-kDa, Proto-Oncogene Proteins c-akt, PTEN Phosphohydrolase, Young Adult, Class I Phosphatidylinositol 3-Kinases, Antibodies, Monoclonal, Humanized
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