JCO Early Release, published online ahead of print Mar 30 2009
Journal of Clinical Oncology, 10.1200/JCO.2008.20.0766
Received September 11, 2008
Accepted January 21, 2009
Targeting the mTOR Signaling Network for Cancer Therapy
Funda Meric-Bernstam and Ana Maria Gonzalez-Angulo
From the Departments of Surgical Oncology and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
The serine-threonine kinase mammalian target of rapamycin (mTOR) plays a major role in the regulation of protein translation, cell growth, and metabolism. Alterations of the mTOR signaling pathway are common in cancer, and thus mTOR is being actively pursued as a therapeutic target. Rapamycin and its analogs (rapalogs) have proven effective as anticancer agents in a broad range of preclinical models. Clinical trials using rapalogs have demonstrated important clinical benefits in several cancer types; however, objective response rates achieved with single-agent therapy have been modest. Rapalogs may be more effective in combination with other anticancer agents, including chemotherapy and targeted therapies. It is increasingly apparent that the mTOR signaling network is quite complex, and rapamycin treatment leads to different signaling responses in different cell types. A better understanding of mTOR signaling, the mechanism of action of rapamycin, and the identification of biomarkers of response will lead to more optimal targeting of this pathway for cancer therapy.