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Molecular Profile Indication/Tumor Type Response Type Relevant Treatment Approaches Therapy Name Approval Status Evidence Type Efficacy Evidence References
PIK3CA act mut lung non-small cell carcinoma sensitive PI3K Inhibitor (Pan) Pictilisib Preclinical - Cell line xenograft Actionable In preclinical studies, the PI3K inhibitor GDC-0941 demonstrated efficacy against NSCLC tumor cell lines in culture and in xenograft models harboring alterations in the PI3K pathway (PMID: 23136191). 23136191
PIK3CA act mut Advanced Solid Tumor conflicting PIK3CA inhibitor Taselisib Preclinical - Cell line xenograft Actionable In a preclinical study, Taselisib (GDC-0032) effectively suppressed growth of multiple tumor types in cell line xenograft models, with greater selectivity for PIK3CA activating mutants (PMID: 23662903). 23662903
PIK3CA act mut breast cancer sensitive PIK3CA inhibitor Copanlisib Preclinical Actionable In a preclinical study, breast cancer cell lines with a PIK3CA activating mutation and/or ERBB2 (HER2) over expression demonstrated increased sensitivity to inhibition of proliferation by Aliqopa (copanlisib) in culture, compared to ERBB2 (HER2)-negative and wild-type PIK3CA cell lines (PMID: 24170767). 24170767
PIK3CA act mut Advanced Solid Tumor sensitive Akt1 Inhibitor Akt2 Inhibitor BAY1125976 Preclinical Actionable In a preclinical study, BAY1125976 demonstrated anti-tumor efficacy in multiple xenograft tumor models of different cancers with PIK3CA mutations or PTEN deletions and displayed synergy with other anti-cancer therapies (Cancer Res 2013;73(8 Suppl):Abstract nr 2050). detail...
PIK3CA act mut Advanced Solid Tumor sensitive mTORC1 Inhibitor Everolimus Preclinical - Cell line xenograft Actionable In a preclinical study, Afinitor (everolimus) demonstrated efficacy in multiple cancer cell lines in culture and xenograft models with PIK3CA activating mutations (PMID: 20664172). 20664172
PIK3CA act mut Advanced Solid Tumor sensitive mTOR Inhibitor Metformin Preclinical Actionable In a preclinical study, Glucophage (metformin) demonstrated efficacy in treating dietary restriction-resistant human xenograft tumors harboring a PIK3CA-activating mutation (PMID: 23986086). 23986086
PIK3CA act mut Advanced Solid Tumor sensitive Akt Inhibitor (Pan) Ipatasertib + Paclitaxel Phase I Actionable In a Phase Ib trial, the combination of Ipatasertib (GDC-0068) and Taxol (paclitaxel) resulted in an objective response rate (ORR) of 8.0% (2/25, partial responses) in patients with advanced solid tumors (n=25), and ORR was proportionally higher in patients harboring activating PIK3CA mutations (2/6) compared to patients without PIK3CA activating mutations (0/19) (PMID: 32205017; NCT01362374). 32205017
PIK3CA act mut Advanced Solid Tumor sensitive Akt Inhibitor (Pan) Afuresertib Preclinical Actionable In a preclinical study, various tumor cell lines harboring PI3KCA activating mutations demonstrated increased sensitivity to Afuresertib (GSK2110183) in cultured cells (PMID: 24978597). 24978597
PIK3CA act mut breast cancer sensitive Akt Inhibitor (Pan) MK2206 Preclinical Actionable In a preclinical study, breast cancer cell lines harboring activating mutations in PIK3CA had increased sensitivity to MK2206 in cell culture (PMID: 22932669). 22932669
PIK3CA act mut head and neck squamous cell carcinoma sensitive mTOR Inhibitor PI3K Inhibitor (Pan) Gedatolisib Preclinical Actionable In a preclinical study, PF-05212384 decreased viability of head and neck squamous carcinoma cells harboring a PIK3CA activating mutation in cell culture (PMID: 24823695). 24823695
PIK3CA act mut ovarian clear cell adenocarcinoma sensitive mTOR Inhibitor PI3K Inhibitor (Pan) Dactolisib Preclinical Actionable In a preclinical study, BEZ235 demonstrated efficacy in mouse xenograft models of ovarian clear cell adenocarcinoma with PIK3CA mutations (PMID: 24927217). 24927217
PIK3CA act mut breast cancer predicted - sensitive Akt Inhibitor (Pan) mTORC1 Inhibitor MK2206 + Ridaforolimus Phase I Actionable In a Phase I clinical trial, Ridaforolimus in combination with MK-2206 demonstrated clinical activity in breast cancer patients expressing a PI3K pathway dependent gene expression signature, with complete response in 14.3% (2/14), partial response in 12.5% (2/16), and 2 patients achieving stable disease (PMID: 26187616). 26187616
PIK3CA act mut Advanced Solid Tumor sensitive mTOR Inhibitor PI3K Inhibitor (Pan) GSK1059615 Preclinical Actionable In a preclinical study, solid tumor cell lines harboring PIK3CA activating mutations demonstrated increased sensitivity to GSK1059615 in culture (Clin Cancer Res October 1, 2008 14; B37). detail...
PIK3CA act mut lung small cell carcinoma predicted - sensitive PI3K Inhibitor (Pan) Navitoclax + Pictilisib Preclinical - Cell line xenograft Actionable In a preclinical study, the combination of Navitoclax (ABT-263) and GDC-0941 resulted in increased tumor growth delay and apoptosis in a small cell lung cancer cell line xenograft model harboring a PIK3CA activating mutation compared to either drug alone (PMID: 27197306). 27197306
PIK3CA act mut estrogen-receptor positive breast cancer predicted - sensitive Akt Inhibitor (Pan) Capivasertib + Tamoxifen Preclinical - Cell culture Actionable In a preclinical study, the combination of AZD5363 and 4-hydroxytamoxifen (4-OHT) worked synergistically or additively to inhibit growth of several estrogen receptor-positive breast cancer cell lines in culture, including cell lines with PIK3CA activating mutations, and overcame tamoxifen resistance in a resistant cell line (PMID: 26116361). 26116361
PIK3CA act mut breast cancer no benefit mTOR Inhibitor PI3K Inhibitor (Pan) Dactolisib + Venetoclax Preclinical - Cell culture Actionable In a preclinical study, inhibition of Pi3k signaling by BEZ235 did not sensitize breast cancer cell lines harboring PIK3CA activating mutations to Venclexta (venetoclax) in culture (PMID: 27974663). 27974663
PIK3CA act mut breast cancer predicted - sensitive mTOR Inhibitor PI3K Inhibitor (Pan) Dactolisib + WEHI-539 Preclinical - Cell culture Actionable In a preclinical study, inhibition of Pi3k signaling by BEZ235 sensitized breast cancer cell lines harboring PIK3CA activating mutations to WEHI-539 in culture (PMID: 27974663). 27974663
PIK3CA act mut breast cancer no benefit PI3K Inhibitor (Pan) Buparlisib + WEHI-539 Preclinical - Cell culture Actionable In a preclinical study, Buparlisib (BKM120) did not sensitize breast cancer cell lines harboring PIK3CA activating mutations to WEHI-539 in culture (PMID: 27974663). 27974663
PIK3CA act mut breast cancer no benefit PIK3CA inhibitor Alpelisib + WEHI-539 Preclinical - Cell culture Actionable In a preclinical study, Alpelisib (BYL719) did not sensitize breast cancer cell lines harboring PIK3CA activating mutations to WEHI-539 in culture (PMID: 27974663). 27974663
PIK3CA act mut breast cancer predicted - sensitive mTOR Inhibitor Torin 1 + WEHI-539 Preclinical - Cell culture Actionable In a preclinical study, the ATP-competitive mTORC1/2 inhibitor Torin1 sensitized breast cancer cell lines harboring PIK3CA activating mutations to WEHI-539 in culture (PMID: 27974663). 27974663
PIK3CA act mut breast cancer predicted - sensitive mTOR Inhibitor Sapanisertib + WEHI-539 Preclinical - Cell culture Actionable In a preclinical study, the ATP-competitive mTORC1/2 inhibitor Sapanisertib (MLN0128) sensitized breast cancer cell lines harboring PIK3CA activating mutations to WEHI-539 in culture (PMID: 27974663). 27974663
PIK3CA act mut breast cancer predicted - sensitive mTOR Inhibitor Vistusertib + WEHI-539 Preclinical - Cell culture Actionable In a preclinical study, the ATP-competitive mTORC1/2 inhibitor Vistusertib (AZD2014) sensitized breast cancer cell lines harboring PIK3CA activating mutations to WEHI-539 in culture (PMID: 27974663). 27974663
PIK3CA act mut triple-receptor negative breast cancer predicted - sensitive mTORC1 Inhibitor Bevacizumab + Doxorubicin + Everolimus Phase I Actionable In a Phase I trial, triple-receptor negative breast cancer patients, including those with PIK3CA activating mutations, demonstrated an overall response rate of 21% (11/52) and clinical benefit rate of 40% (21/52) when treated with a combination of Avastin (bevacizumab), Adriamycin (doxorubicin), and either Afinitor (everolimus) or Torisel (temsirolimus) (PMID: 27893038). 27893038
PIK3CA act mut triple-receptor negative breast cancer predicted - sensitive mTORC1 Inhibitor Bevacizumab + Doxorubicin + Temsirolimus Phase I Actionable In a Phase I trial, triple-receptor negative breast cancer patients, including those with PIK3CA activating mutations, demonstrated an overall response rate of 21% (11/52) and clinical benefit rate of 40% (21/52) when treated with a combination of Avastin (bevacizumab), Adriamycin (doxorubicin), and either Afinitor (everolimus) or Torisel (temsirolimus) (PMID: 27893038). 27893038
PIK3CA act mut head and neck squamous cell carcinoma predicted - sensitive mTOR Inhibitor PI3K Inhibitor (Pan) AZD8055 + Cetuximab Preclinical - Pdx Actionable In a preclinical study, two head and neck squamous cell carcinoma patient-derived xenograft (PDX) models harboring a PIK3CA activating mutation demonstrated greater delayed tumor growth when treated with a combination of AZD8055 and Erbitux (cetuximab) compared to either agent alone (PMID: 28446642). 28446642
PIK3CA act mut Advanced Solid Tumor conflicting PIK3CA inhibitor Taselisib Phase II Actionable In a Phase II trial (MATCH), Taselisib (GDC-0032) treatment resulted in limited efficacy in heavily pretreated patients with advanced solid tumors harboring PIK3CA activating mutations, with an objective response rate of 0% (0/61) after a median follow-up of 35.7 months, stable disease in 52% (32/61), a median progression-free survival of 3.1 months, and a median overall survival of 7.2 months (PMID: 35138919; NCT02465060). 35138919
PIK3CA act mut breast cancer sensitive PIK3CA inhibitor Copanlisib Phase I Actionable In a Phase I clinical trial, treatment with Aliqopa (copanlisib) resulted in partial response in one and stable disease in another patient with breast cancer harboring activating PIK3CA mutations (PMID: 27672108; NCT00962611). 27672108
PIK3CA act mut lung squamous cell carcinoma predicted - sensitive PI3K Inhibitor (Pan) Buparlisib Preclinical - Pdx Actionable In a preclinical study, Buparlisib (BKM120) treatment resulted in inhibition of AKT and S6 phosphorylation and durable responses in 4/5 lung squamous cell carcinoma patient-derived xenograft (PDX) models harboring PIK3CA E545K or E542K mutations, 3 that also had PIK3CA amplification and 1 with PTEN loss (PMID: 30093452). 30093452
PIK3CA act mut lung squamous cell carcinoma predicted - sensitive PIK3CA inhibitor Alpelisib Preclinical - Pdx Actionable In a preclinical study, Alpelisib (BYL719) treatment resulted in responses in multiple lung squamous cell carcinoma patient-derived xenograft (PDX) models harboring PIK3CA E545K or E542K mutations, including models with PIK3CA amplification or PTEN loss (PMID: 30093452). 30093452
PIK3CA act mut lung non-small cell carcinoma predicted - resistant Osimertinib Case Reports/Case Series Actionable In a retrospective analysis, activating PIK3CA mutations were identified in 6 of 100 patients with non-small cell lung cancer at treatment discontinuation of Tagrisso (osimertinib) (PMID: 31839416). 31839416
PIK3CA act mut triple-receptor negative breast cancer predicted - sensitive Akt Inhibitor (Pan) Capivasertib + Paclitaxel Phase II Actionable In a Phase II trial (PAKT), addition of Capivasertib (AZD5363) to Taxol (paclitaxel) as first-line therapy significantly improved median progression-free survival (9.3 vs 3.7 months, HR=0.30, p=0.01) and reduced risk (66%, HR=0.34, p=0.04) compared to Taxol (paclitaxel) alone in patients with metastatic triple-negative breast cancer harboring activating mutations in AKT1 (E17K, n=1) or PIK3CA (n=17), or inactivating mutations or gene loss in PTEN (n=13) (PMID: 31841354; NCT02423603). 31841354
PIK3CA act mut estrogen-receptor positive breast cancer predicted - sensitive PIK3CA inhibitor Palbociclib + Taselisib Phase I Actionable In a Phase Ib trial (PIPA), the combination of Ibrance (palbociclib) with Taselisib (GDC-0032) was well tolerated in estrogen-receptor negative breast cancer patients harboring PIK3CA activating mutations and resulted in an objective response rate of 10% (1/10), a clinical benefit rate of 30% (4/10), and a median progression-free survival of 3.6 months (PMID: 32958578; NCT02389842). 32958578
PIK3CA act mut Advanced Solid Tumor predicted - sensitive PIK3CA inhibitor Palbociclib + Taselisib Phase I Actionable In a Phase Ib trial (PIPA), the combination of Ibrance (palbociclib) with Taselisib (GDC-0032) was well tolerated in patients with advanced solid tumors harboring PIK3CA activating mutations and resulted in an objective response rate of 0% (0/12), a clinical benefit rate of 16.7% (2/12), and a median progression-free survival of 3.8 months (PMID: 32958578; NCT02389842). 32958578
PIK3CA act mut triple-receptor negative breast cancer no benefit Akt Inhibitor (Pan) Ipatasertib + Paclitaxel Phase II Actionable In a Phase II trial (LOTUS), Ipatasertib (GDC-0068) in combination with Abraxane (paclitaxel) resulted a median progression free survival of 6.2 vs 4.9 months with placebo in triple-receptor negative breast cancer patients harboring activating mutations in PIK3CA or AKT1, or inactivating mutations in PTEN (PMID: 28800861; NCT02162719). 28800861
PIK3CA act mut triple-receptor negative breast cancer no benefit Akt Inhibitor (Pan) Ipatasertib + Paclitaxel Phase III Actionable In a Phase III trial (IPATunity 130), the addition of Ipatasertib (GDC-0068) to treatment with Abraxane (paclitaxel) did not result in improved progression-free survival in patients with triple-negative breast cancer harboring PIK3CA and/or AKT activating mutations or PTEN alterations, with a median PFS of 7.4 months with Ipatasertib (GDC-0068) plus Abraxane (paclitaxel) vs. 6.1 months with placebo plus Abraxane (paclitaxel) (SABCS Meeting 2020, Abstract GS3-04; NCT03337724). detail...
PIK3CA act mut Advanced Solid Tumor no benefit Akt Inhibitor (Pan) TAS-117 Phase II Actionable In a Phase II trial, TAS-117 treatment in advanced solid tumor patients with PIK3CA activating mutations (n=12) or AKT1 E17K (n=1) refractory to standard treatment had minimal activity, and led to an overall response rate of 8% (1/13), disease control rate of 23% (3/13), median progression-free survival of 1.4 months (mo), and a median overall survival of 4.8 mo, however due to poor accrual and lack of durable response to TAS-117 early termination of study was recommended (PMID: 33723724; NCT03017521). 33723724
PIK3CA act mut Advanced Solid Tumor predicted - sensitive mTOR Inhibitor PI3K Inhibitor (Pan) LY3023414 + Prexasertib Phase I Actionable In a Phase Ib trial, the combination therapy of Samotolisib (LY3023414) and Prexasertib (LY2606368) resulted in an overall response rate of 13.3% (2/15; 2 partial responses) in patients with an advanced solid tumor harboring a PIK3CA activating mutation of either H1047R, H1047L, E542K, or E545K (PMID: 33495309; NCT02124148). 33495309
PIK3CA act mut endometrial cancer no benefit mTOR Inhibitor PI3K Inhibitor (Pan) LY3023414 Phase II Actionable In a Phase II trial, patients with advanced endometrial cancer harboring a PI3K pathway mutation, including PIK3CA activating mutations, demonstrated only a modest clinical benefit with an overall response rate of 16% (4/25), a clinical benefit rate of 28% (7/25) at 12 weeks, a progression-free survival of 2.5 months, and overall survival of 9.2 months when treated with LY3023414 (PMID: 31880826; NCT01775072). 31880826
PIK3CA act mut Her2-receptor negative breast cancer predicted - sensitive PIK3CA inhibitor Alpelisib + Nab-paclitaxel Clinical Study - Cohort Actionable In a Phase I/II trial, Piqray (Alpelisib) and Abraxane (nab-paclitaxel) combination treatment resulted in improved clinical benefit rate (100% vs 68%; OR=1.47, P=0.013) and median progression-free survival (11.9 vs 7.5 mo.; HR=0.44, P=0.027) and longer median overall survival (26.7 vs. 14.9 mo.; HR=0.59, P=0.19) in patients with ERBB2 (HER2)-negative metastatic breast cancer harboring activating PIK3CA mutations compared to patients without PIK3CA mutations (PMID: 33602685; NCT02379247). 33602685
PIK3CA act mut Advanced Solid Tumor predicted - sensitive Akt Inhibitor (Pan) Docetaxel + Ipatasertib Phase I Actionable In a Phase Ib trial, the combination of Ipatasertib (GDC-0068) and Taxotere (docetaxel) resulted in an objective response rate (ORR) of 7.7% (2/26, partial responses) in patients with advanced solid tumors (n=26), and ORR was proportionally higher in patients harboring activating PIK3CA mutations (1/4) compared to patients without PIK3CA activating mutations (1/22) (PMID: 32205017; NCT01362374). 32205017
PIK3CA act mut Advanced Solid Tumor predicted - sensitive Akt Inhibitor (Pan) Fluorouracil + Ipatasertib + Leucovorin + Oxaliplatin Phase I Actionable In a Phase Ib trial, the combination of Ipatasertib (GDC-0068) and mFOLFOX6 resulted in an objective response rate (ORR) of 6.1% (2/33, partial responses) in patients with advanced solid tumors (n=33), and ORR was proportionally higher in patients harboring activating PIK3CA mutations (1/4) compared to in patients without PIK3CA activating mutations (1/29) (PMID: 32205017; NCT01362374). 32205017
PIK3CA act mut castration-resistant prostate carcinoma predicted - sensitive mTOR Inhibitor CC-115 + Enzalutamide Phase I Actionable In a Phase Ib trial, combination of Xtandi (enzalutamide) and CC-115 was safe and resulted in a PSA reduction >= 50% (PSA50) in 80% and >=90% (PSA90) in 58% of patients with metastatic castration-resistant prostate cancer at 12 weeks, patients harboring PIK3CA activating mutations or TSC1/2 loss (n=16) achieved superior PSA50, PSA90, and median time on treatment (94%, 63%, 57 wks) compared to PI3K pathway wild-type (n=24) patients (71%, 54%, 44 wks) (Ann Oncol (2021) 32 (suppl_5): S626-S677; NCT02833883). detail...
PIK3CA act mut Advanced Solid Tumor predicted - sensitive PIK3CA inhibitor RLY-2608 Preclinical - Cell line xenograft Actionable In a preclinical study, RLY-2608 treatment led to inhibition of cell viability in a panel of cancer cell lines harboring PIK3CA hotspot mutations, and led to tumor regression or stasis in cell line xenograft models (Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P251). detail...