mTOR signaling in osteosarcoma: Oncogenesis and therapeutic aspects (Review).

The mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that belongs to the phosphoinositide-3-kinase (PI3K)-related kinase family. Oncogenic activation of mTOR signaling significantly contributes to the progression of different types of cancers including osteosarcoma (OS; the most common primary malignant tumor of bone). In the present study, we review the association of the mTOR signaling pathway with OS, and the possible effective treatment strategies by targeting this pathway. In the metastatic behavior of OS, one of the most common actionable aberrations was found in the PI3K/Akt/mTOR pathway. Upon phosphorylation, activated mTOR contributes to OS cellular transformation and poor cancer prognosis via downstream effectors such as S6K1, 4EBP1 and eIF4E, which are overexpressed in OS. Targeting the mTOR complex is a significant approach in cancer therapeutic research, and of course, rapamycin is the primary inhibitor of mTOR. Various other chemotherapeutic molecules have also shown potential activity against mTOR. As mTOR is a new promising oncological target and blockade of the mTOR pathway with selective inhibitors has significant potential in OS therapeutic research, the development of the optimal dose, regimen and a rationale for the use of mTOR inhibitors in combination with other anticancer agents may provide a successful treatment strategy for OS.