Efficient Everolimus Treatment for Metastatic Castration Resistant Prostate Cancer with AKT1 Mutation: A Case Report

• Main Authors: Yu Z, Wei W, Liu H, Pan E, Yang P, Jiang K
• Format: Article in Journal/Newspaper
• Language: English
• Published: Dove Medical Press 2021
• Subjects: castration resistant prostate cancer; androgen receptor; everolimus; next-generation sequencing; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282; Evenki
• Online Access: https://doaj.org/article/5d35a63a08f5485ab628ffdc6709b4e2

Zhe Yu,1,* Wei Wei,1,* Hongruo Liu,1 Evenki Pan,2 Peng Yang,2 Kui Jiang1 1Department of Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China; 2Nanjing Genesseq Technology Inc., Nanjing, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kui JiangDepartment of Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of ChinaEmail [e-mail]: Metastatic castration resistant prostate cancer (mCRPC), the advanced stage of prostate cancer (PCa), develops resistance to first line androgen deprivation therapy (ADT). Aberrant androgen receptor (AR) and PI3K-Akt-mTOR signaling pathway are responsible for the development and progression of mCRPC. We herein describe a case of a 64-year-old male mCRPC patient with somatic AKT1 and AR mutations. The patient, who had been heavily pretreated by ADT and AR inhibitors, showed stable disease progression when he received everolimus, an mTOR inhibitor. The PSA level dropped drastically from 1493.0 ng/mL to 237.6 ng/mL, after 3 months of treatment. The overall survival (OS) was 43 months, of which the progression-free survival (PFS) with everolimus treatment was 7 months. The administration of mTOR inhibitor, everolimus, could achieve good clinical responses along with prolonging PFS for mCRPC patients harboring AKT1 mutations. Technology in precision medicine, such as targeted next-generation sequencing (NGS) of cancer-relevant genes, has promising function in personalized therapy.Keywords: castration resistant prostate cancer, androgen receptor, everolimus, next-generation sequencing