PI3K Inhibitors in Cancer: Clinical Implications and Adverse Effects

Int J Mol Sci. 2021 Mar 27;22(7):3464. doi: 10.3390/ijms22073464.

Abstract

The phospatidylinositol-3 kinase (PI3K) pathway is a crucial intracellular signaling pathway which is mutated or amplified in a wide variety of cancers including breast, gastric, ovarian, colorectal, prostate, glioblastoma and endometrial cancers. PI3K signaling plays an important role in cancer cell survival, angiogenesis and metastasis, making it a promising therapeutic target. There are several ongoing and completed clinical trials involving PI3K inhibitors (pan, isoform-specific and dual PI3K/mTOR) with the goal to find efficient PI3K inhibitors that could overcome resistance to current therapies. This review focuses on the current landscape of various PI3K inhibitors either as monotherapy or in combination therapies and the treatment outcomes involved in various phases of clinical trials in different cancer types. There is a discussion of the drug-related toxicities, challenges associated with these PI3K inhibitors and the adverse events leading to treatment failure. In addition, novel PI3K drugs that have potential to be translated in the clinic are highlighted.

Keywords: PI3K inhibitors; PIK3CA; cancer; resistance.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology
  • Class I Phosphatidylinositol 3-Kinases / metabolism
  • Clinical Trials as Topic
  • Drug Resistance, Neoplasm / drug effects
  • Drug-Related Side Effects and Adverse Reactions / drug therapy
  • Humans
  • Insulin / metabolism
  • Mice
  • Mutation
  • Neoplasms / drug therapy*
  • Neoplasms / enzymology
  • Neovascularization, Pathologic / drug therapy*
  • Phosphatidylinositol 3-Kinases / metabolism*
  • Phosphoinositide-3 Kinase Inhibitors / pharmacology*
  • Protein Isoforms
  • RNA, Untranslated / metabolism
  • Signal Transduction*
  • TOR Serine-Threonine Kinases / metabolism

Substances

  • Antineoplastic Agents
  • Insulin
  • Phosphoinositide-3 Kinase Inhibitors
  • Protein Isoforms
  • RNA, Untranslated
  • MTOR protein, human
  • Class I Phosphatidylinositol 3-Kinases
  • PIK3CA protein, human
  • TOR Serine-Threonine Kinases