Expression of the PI3K/AKT/mTOR pathway as a prognostic factor in patients with advanced high grade serous ovarian carcinoma treated with neoadjuvant chemotherapy

Background: The aim of this study was to search biomarkers in patients with high grade serous ovarian carcinoma (HGSOC) treated with neoadjuvant chemotherapy (NACT) among the components of PI3K/AKT/mTOR pathway. Material and Methods: The authors assessed 49 patients with HGSOC (FIGO IIIC-IV) treated with NACT. The expression of PI3KCA, PTEN, pAKT473, mTOR, and p70S6K were assessed immunohistochemically. Results: The expression of PI3KCA and p70S6K in tumour tissue after NACT was significantly decreased compared to before chemotherapy (p = 0.0005 and p = 0.0256, respectively). Multivariate analysis demonstrated that high mTOR expression, suboptimal range of interval debulking surgery (IDS), platinum resistance, and the lack of paclitaxel in the NACT were independent adverse prognostic factors (HR=3.86, 95% CI (1.75-8.56); HR = 3.94, 95% CI (1.76-8.83); HR = 2.29, 95% CI (1.13-4.64); and HR- 4.76, 95% CI (1.80-12.59),p < 0.05). Conclusions: The mTOR expression may be an independent prognostic factor, but further investigations are needed.