Abstract

Ovarian cancer is the most lethal gynecologic malignancy in the United States, with an estimated 22,530 new cases and 13,980 deaths in 2019. Recent studies have indicated that the phosphoinositol 3 kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR), as well as the nuclear factor-κ light chain enhancer of activated B cells (NFκB) pathways are highly mutated and/or hyper-activated in a majority of ovarian cancer patients, and are associated with advanced grade and stage disease and poor prognosis. In this review, we will investigate PI3K/AKT/mTOR and their interconnection with NFκB pathway in ovarian cancer cells.

Highlights

  • Ovarian cancer (OvCa) is the fifth most common type of cancer and the primary cause of gynecological cancer death in the United States [1]

  • The Cancer Genome Altas (TCGA) data revealed the hyperactivation of phosphoinositol 3 kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway in nearly 60% of patients with OvCa [1]

  • Several studies have reported that nearly 41% and 26.4% of high-grade serous cancer (HGSC) express the phosphorylated form of mTOR1 targets 4EBP1 and 70S6K, respectively, implying that mTORC1 activity is associated with a more aggressive phenotype and poor prognosis [126]

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Summary

Introduction

Ovarian cancer (OvCa) is the fifth most common type of cancer and the primary cause of gynecological cancer death in the United States [1]. The Cancer Genome Altas (TCGA) data revealed the hyperactivation of phosphoinositol 3 kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) (PI3K/AKT/mTOR) pathway in nearly 60% of patients with OvCa [1]. This pathway plays significant multifaceted roles in cancer cell growth, survival, metabolic programing, autophagy, transcription regulation, and angiogenesis [5,6,7]. The mutation profile of serous ovarian cystadenocarcinoma, generated from cBioPortal for Cancer Genomics (http://www.cbioportal.org/), indicates that several key players in the PI3K/AKT/mTOR/NFκB pathway are hyperactivated (Figure 1).

Structural Overview
Interactions of PI3K with Upstream Regulators
Interactions of PI3K with Downstream Effectors
The Importance of PI3K 110α in OvCa
Correlation of PI3K Mutations in OvCa with Standard of Care Therapy
Upstream AKT Activation
Downstream Effectors of AKT
AKT in OvCa
Upstream Activation of mTORC1
Downstream Effectors of mTORC1
Upstream Regulators of mTORC2
Downstream Effectors of mTORC2
Canonical Pathway
Non-Canonical Pathway
Regulation of NFκB
PI3K-AKT-mTOR-NFκB Axis
Correlation between the nodes nodesofofPI3K-AKT-mTOR
Therapeutic Targeting of PI3K-AKT-mTOR-NFκB in Preclinical Models of OvCa
Therapeutic Targeting of PI3K-AKT-mTOR-NFκB in Clinical Trials
Findings
Conclusions

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