Oncology Today with Dr Neil Love AKT Inhibition in Prostate Cancer — Proceedings from a Session Held Adjunct to the 2026 ASCO Genitourinary Cancers Symposium
Mar 30, 2026
Prof Karim Fizazi, an academic oncologist focused on genitourinary cancers, and Dr Daniel George, a prostate cancer clinical investigator at Duke, discuss AKT inhibition and PTEN deficiency in metastatic prostate cancer. They cover biomarker testing methods, rationale for AKT targeting, trial results including CAPItello-281, toxicity management, timing of therapy, and clinical integration of AKT inhibitors.
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Test PTEN With IHC First
- Use PTEN immunohistochemistry as a practical, scalable first test because it directly measures protein and works on small archival biopsies.
- Reserve NGS when you need broader genomic context; IHC ≥90% loss correlates ~90% with sequencing and is faster and cheaper.
PTEN Loss Causes PSA‑Discordant Progression
- PTEN‑deficient tumors often progress without a marked PSA rise because growth is driven by PI3K‑AKT rather than AR‑driven PSA expression.
- This leads to radiographic or symptomatic progression despite apparently controlled PSA.
Rely On Archival Tissue For PTEN IHC When Possible
- Use archival primary tissue for PTEN IHC in most cases because it is usually informative and avoids repeat biopsy; re-biopsy only if archival tissue is unavailable or too old.
- IHC ≥90% threshold was chosen to match NGS and enable global scalability.