Gliomas represent the most common primary brain tumor and are among the most lethal of all cancers.
EGFR is commonly mutated in GBM, leading to overexpression and activation of downstream signaling pathways. EGFR signals through a complex network of intermediates, including PI3K/AKT/mTOR, MAPK, and PLCγ. Inactivation of
PTEN and activating mutations in PI3K itself collectively occur in a majority of GBM tumors, effectively uncoupling PI3K from upstream control by EGFR (
1).
PI3Ks are lipid kinases activated by a wide range of RTKs to generate the second messenger phosphatidylinositol-3,4,5-trispho- couples PI3K to downstream effectors, such as sphate (PIP
3). PIP
3 Akt, a serine-threonine kinase that suppresses apoptosis, promotes growth, and drives proliferation. PIP
3 also indirectly activates the mammalian target of rapamycin (mTOR), a protein kinase critical for cell growth (
1). The mTOR kinase contains a PI3K homology domain (making mTOR a PIK-related kinase – PIKK), although mTOR itself has no lipid kinase activity (
2).
Signaling functions of mTOR are distributed between at least two distinct mTOR protein complexes: mTORC1 and mTORC2. In mTORC1, mTOR is associated with a number of proteins, including PRAS40 and the rapamycin-sensitive adapter protein of mTOR (Raptor), whereas in mTORC2, mTOR is associated with a separate protein complex, including the rapamycin-insensitive companion of mTOR (Rictor). Stimulation of PI3K in response to growth factors leads to phosphorylation and activation of Akt. In addition, phospho-Akt phosphorylates and separately inhibits PRAS40 and the Tsc1/2 (hamartin-tuberin) complex. PRAS40 is inhibitory to mTORC1, while tuberin is inhibitory to GTPase RHEB, which in turn is inhibitory to mTORC1. The detailed signaling leading to activation of mTORC2 is less clearly understood (
3).
The activated mTORC1 complex phosphorylates substrates, including Thr-389 S6K, Ser-209 eIF4E, and 4EBP1. The mTORC2 complex phosphorylates Akt on Ser-473, and also phosphorylates additional substrates, including serum glucocorticoid-induced protein kinase (SGK) and PKCα Inhibition of mTORC1/S6K1 by allosteric inhibitors, including rapamycin (Sirolimus) (), CCI-779 (Tensirolimus), RAD001 (
4), or other similar agents triggers a negative feedback loop through an IRS-I-dependent mechanism, resulting in increase phosphorylation of Akt. This negative feedback loop is prominent in glioma, however the robustness with which inhibition of mTORC1 activates Akt varies across multiple cancer types (
5–
7). Unlike rapamycin, ATP-competitive inhibitors of mTORC1/mTORC2 by mTOR inhibitors, including Torin, Ku-0063794 (
8,
9), and pp242 (
10) blocks the phosphorylation of Akt at Ser473. As an integrator of cell growth and proliferation, mTOR also regulates autophagy, a program of cellular self-digestion activated during periods of nutrient and growth factor deprivation (
11). The signaling linking activation of mTOR signaling to blockade of autophagy in metazoan cells is poorly understood.
Preclinical evaluation of dual PI3K/mTOR inhibitors, such as PI-103 and NVP-BEZ235 have demonstrated efficacy for these agents in blocking the growth of glioblastoma (GBM) cells
in vitro and
in vivo (
5,
12). NVP-BEZ235 and other dual inhibitors are therefore being evaluated in early clinical trials. Thus, inhibitors of mTOR and of PI3K/mTOR provide a new class of agents and therapeutic for glioma. Pure ATP-competitive inhibitors of mTORC1/2 inhibit both mTOR complexes, and have been evaluated in less detail in glioma. We have directly compared rapamycin, Ku-0063794, PI-103, or siRNA against mTOR in glioma cells. In contrast to rapamycin, both Ku-0063794 and PI-103 blocked the phosphorylation of Akt and prevented its activation. Ku-0063794 and PI-103 also decreased the phosphorylation of the mTORC1 target 4EBP1 and induced autophagy more effectively in comparison with the allosteric mTORC1 inhibitor rapamycin ( and ).