Mechanisms of resistance to mTOR inhibitors

Crit Rev Oncol Hematol. 2020 Mar:147:102886. doi: 10.1016/j.critrevonc.2020.102886. Epub 2020 Jan 29.

Abstract

In several tumors the PI3K/AKT/mTOR pathway is frequently disrupted, an event that results in uncontrolled cell proliferation and tumor growth. Through the years, several compounds have been developed to inhibit the pathway at different steps: the mammalian target of rapamycin (mTOR) seemed to be the most qualified target. However, this kinase has such a key role in cell survival that mechanisms of resistance are rapidly developed. Nevertheless, clinical results obtained with mTOR inhibitors in breast cancer, renal cell carcinoma, neuroendocrine tumors and mantle cell lymphoma push oncologists to actively further develop these drugs, maybe by better selecting the population to which they are offered, through the research of predictive factors of responsiveness. In this review, we aim to describe mechanisms of resistance to mTOR inhibitors, from preclinical and clinical perspectives.

Keywords: Mechanisms of resistance; Predictive factors; mTOR inhibitors.

Publication types

  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism*
  • Cell Proliferation
  • Drug Resistance, Neoplasm
  • Humans
  • Lymphoma, Mantle-Cell*
  • Phosphatidylinositol 3-Kinase / metabolism*
  • Phosphatidylinositol 3-Kinases / physiology*
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins c-akt / metabolism*
  • TOR Serine-Threonine Kinases / metabolism*

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • MTOR protein, human
  • Phosphatidylinositol 3-Kinase
  • Proto-Oncogene Proteins c-akt
  • TOR Serine-Threonine Kinases