Targeting mTOR dependency in pancreatic cancer

Morran, D. C. et al. (2014) Targeting mTOR dependency in pancreatic cancer. Gut, 63(9), pp. 1481-1489. (doi: 10.1136/gutjnl-2013-306202) (PMID:24717934) (PMCID:PMC4145424)

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Objective: Pancreatic cancer is a leading cause of cancer-related death in the Western world. Current chemotherapy regimens have modest survival benefit. Thus, novel, effective therapies are required for treatment of this disease. Design: Activating KRAS mutation almost always drives pancreatic tumour initiation, however, deregulation of other potentially druggable pathways promotes tumour progression. PTEN loss leads to acceleration of KrasG12D-driven pancreatic ductal adenocarcinoma (PDAC) in mice and these tumours have high levels of mammalian target of rapamycin (mTOR) signalling. To test whether these KRAS PTEN pancreatic tumours show mTOR dependence, we compared response to mTOR inhibition in this model, to the response in another established model of pancreatic cancer, KRAS P53. We also assessed whether there was a subset of pancreatic cancer patients who may respond to mTOR inhibition. Results: We found that tumours in KRAS PTEN mice exhibit a remarkable dependence on mTOR signalling. In these tumours, mTOR inhibition leads to proliferative arrest and even tumour regression. Further, we could measure response using clinically applicable positron emission tomography imaging. Importantly, pancreatic tumours driven by activated KRAS and mutant p53 did not respond to treatment. In human tumours, approximately 20% of cases demonstrated low PTEN expression and a gene expression signature that overlaps with murine KRAS PTEN tumours. Conclusions: KRAS PTEN tumours are uniquely responsive to mTOR inhibition. Targeted anti-mTOR therapies may offer clinical benefit in subsets of human PDAC selected based on genotype, that are dependent on mTOR signalling. Thus, the genetic signatures of human tumours could be used to direct pancreatic cancer treatment in the future.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Jamieson, Professor Nigel and Morran, Mr Douglas and Pimlott, Dr Sally and Anderson, Professor Kurt and Biankin, Professor Andrew and Carter, Mr Ross and Champion, Dr Sue and Oien, Professor Karin and Zajac, Dr Malgorzata and Mrowinska, Ms Agata and Gillen, Dr Gerry and Grimmond, Professor Sean and Evans, Professor Jeff and Kalna, Dr Gabriela and Morton, Professor Jen and Chang, Professor David and Karim, Ms Saadia and Sansom, Professor Owen
Authors: Morran, D. C., Wu, J., Jamieson, N. B., Mrowinska, A., Kalna, G., Karim, S. A., Au, A. Y.M., Scarlett, C. J., Chang, D. K., Pajak, M. Z., Oien, K. A., McKay, C. J., Carter, C. R., Gillen, G., Champion, S., Pimlott, S. L., Anderson, K. I., Evans, T.R. J., Grimmond, S. M., Biankin, A. V., Sansom, O. J., and Morton, J. P.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Gut
Publisher:BMJ Publishing Group
ISSN (Online):1468-3288
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in Gut 63(9):1481-1489
Publisher Policy:Reproduced under a Creative Commons License

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