Cancer
mTOR mediated anti-cancer drug discovery

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The mammalian target of rapamycin (mTOR) is an evolutionarily conserved serine/threonine kinase and the founding member of a signaling pathway that regulates many fundamental features of cell growth and division. In cells, mTOR acts as the catalytic subunit of two functionally distinct complexes, called mTOR Complex 1 (mTORC1) and mTOR Complex 2 (mTORC2). Together, these complexes coordinate a variety of processes that include protein translation, autophagy, proliferation, survival and metabolism in response to nutrient, energy and growth factor signals. Consistent with its role as a growth-promoting pathway, numerous studies have found that mTOR signaling is hyper-activated in a broad spectrum of human cancers. In particular, mTORC2 is considered a primary effector of the phosphatidylinositol-3-kinase (PI3K) signaling pathway, which is mutated in a majority of human cancers, in part through its ability to phosphorylate and regulate the proto-oncogene Akt/PKB. Many biological functions of mTOR have been pharmacologically explored using the natural product rapamycin, an allosteric inhibitor that has been reviewed extensively elsewhere. This review will focus specifically on the development of small molecule ATP-competitive inhibitors of mTOR and their prospects as a targeted therapy.

Section editor:

Robert Copeland – Epizyme Inc., Cambridge, MA 02139, USA

Section snippets

Introduction of mTOR signalling pathway

Rapamycin is a 31-membered macrocyclic lactone that was first developed as immunosuppressant by Wyeth in 1997 and more recently as an anti-cancer agent in the form of various analogs, often referred to as rapalogs. In complex with the small protein FKBP12, rapamycin binds to the FKBP12-rapamycin (FRB) domain of mTOR and inhibits its kinase activity through an allosteric mechanism that is still under investigation. Because of its exquisite selectivity, rapamycin has been an indispensable

Rapamycin and rapalogs

Rapamycin was originally identified as an antifungal compound in 1975, later discovered to have anti-tumor activity in 1984, and eventually commercialized as immunosuppressant by Wyeth in 1997. More recently, there has been a renewed interest in its anti-cancer properties, which has sparked the development of several analogs that are collectively referred to as ‘rapalogs.’ Rapamycin has very poor water solubility, severely limiting its bioavailability [18]. Thus, many of the rapalogs, such as

ATP-competitive inhibitors

The development of ATP-competitive mTOR inhibitors has historically been neglected because it was difficult to imagine an ATP-competitive inhibitor competing with the potency and selectivity of the rapalogs. Several factors converged to change this. First was the discovery of mTORC2 complex and its insensitivity to acute inhibition by rapamycin. Second was the discovery that combinations of rapamycin and ATP-competitive PI3K inhibitors or dual-mTOR/PI3K ATP-competitive compounds like PI-103

Future direction

Accumulated evidence has demonstrated that mTOR is a key node in the PI3K/Akt/mTOR signalling pathway, which is arguably the most commonly activated pathway in human cancer. As such, there is a strong rationale for targeting mTOR therapeutically, especially in cancers that are known to carry alterations in PI3K signaling. Several hereditary cancer syndromes are reasonable candidates, such as Cowden's Syndrome (PTEN), Tuberous Sclerosis Complex (TSC1 or TSC2), and Peutz-Jeghers Syndrome

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