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2015 ; 6
(26
): 22081-97
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Activation of PI3K/Akt/mTOR signaling in the tumor stroma drives endocrine
therapy-dependent breast tumor regression
#MMPMID26098779
Polo ML
; Riggio M
; May M
; Rodríguez MJ
; Perrone MC
; Stallings-Mann M
; Kaen D
; Frost M
; Goetz M
; Boughey J
; Lanari C
; Radisky D
; Novaro V
Oncotarget
2015[Sep]; 6
(26
): 22081-97
PMID26098779
show ga
Improved efficacy of neoadjuvant endocrine-targeting therapies in luminal breast
carcinomas could be achieved with optimal use of pathway targeting agents. In a
mouse model of ductal breast carcinoma we identify a tumor regressive stromal
reaction that is induced by neoadjuvant endocrine therapy. This reparative
reaction is characterized by tumor neovascularization accompanied by infiltration
of immune cells and carcinoma-associated fibroblasts that stain for
phosphorylated ribosomal protein S6 (pS6), downstream the PI3K/Akt/mTOR pathway.
While tumor variants with higher PI3K/Akt/mTOR activity respond well to a
combination of endocrine and PI3K/Akt/mTOR inhibitors, tumor variants with lower
PI3K/Akt/mTOR activity respond more poorly to the combination therapy than to the
endocrine therapy alone, associated with inhibition of stromal pS6 and the
reparative reaction. In human breast cancer xenografts we confirm that such
differential sensitivity to therapy is primarily determined by the level of
PI3K/Akt/mTOR in tumor cells. We further show that the clinical response of
breast cancer patients undergoing neoadjuvant endocrine therapy is associated
with the reparative stromal reaction. We conclude that tumor level and
localization of pS6 are associated with therapeutic response in breast cancer and
represent biomarkers to distinguish which tumors will benefit from the
incorporation of PI3K/Akt/mTOR inhibitors with neoadjuvant endocrine therapy.