Oliver's mTOR Atlas Evidence Platform
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Breast cancer

Disease · 8 studies in the Atlas

Hormone-receptor-positive advanced breast cancer becomes resistant to endocrine therapy partly by activating mTOR; adding the rapalog everolimus to exemestane delays progression (BOLERO-2: progression-free survival roughly doubled, without a significant overall-survival benefit).

A cancer where a rapalog is used with hormone therapy. Hormone-driven advanced breast cancer can become resistant to standard hormone therapy partly by switching on mTOR signaling as a workaround. Adding the mTOR-blocking drug everolimus to hormone therapy roughly doubled the time before the cancer grew again, although it did not significantly lengthen overall survival.

BOLERO-2: progression-free survival benefit, no clear overall-survival benefit, meaningful toxicity – a resistance-delaying rather than curative effect.

TL;DR. Breast cancer appears in 8 curated studies in Oliver's mTOR Atlas: 3 in people (3 human studies); 2 in animal models; 3 at the molecular level (cells, biochemistry, structure). It has 1 interaction in the curated pathway model.

In the pathway model

1 interaction in the curated mTOR pathway model. Each row is a claim with the evidence behind it; the evidence code is the kind of study, not its quality.

InteractionMechanismEvidenceStudies
Everolimus inhibits Breast cancer mechanism: clinical-outcome · this link in full · on the map table Adding everolimus to hormone therapy roughly doubled the time before certain advanced breast cancers got worse.BOLERO-2: adding everolimus to hormone therapy roughly doubled progression-free survival in hormone-receptor-positive advanced breast cancer. Holds under: Progression-free survival, in combination with exemestane - overall survival was not significantly improved. shown in people · settled in the literature H BAS2012, PIC2014

Evidence at a glance

EvidenceWhat it meansStudies
H Human study3
A Animal model2
M Molecular — cells, biochemistry, structure3

Human studies in the Atlas

3 studies in people, newest first. Design and population as recorded for each study; the evidence code is the kind of study, not its quality.

YearEvidenceStudyDesign / population
2026 H EVERolimus effectiveness after proGREssion on ENdocrine therapy plus CDK4/6 inhibitor for ER-positive/HER2-negative advanced breast cancer: EVERGREEN study MAR2026 Human (multicenter retrospective cohort)
2014 H Everolimus plus exemestane for hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: overall survival results from BOLERO-2† PIC2014 Humans: postmenopausal women with HR+/HER2- advanced breast cancer after nonsteroidal aromatase inhibitors; phase III RCT, everolimus + exemestane vs placebo + exemestane (2:1)
2012 H Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer (BOLERO-2) BAS2012 Humans, phase 3 RCT (n=724)

Studies

YearEvidenceStudy
2026 H EVERolimus effectiveness after proGREssion on ENdocrine therapy plus CDK4/6 inhibitor for ER-positive/HER2-negative advanced breast cancer: EVERGREEN study MAR2026 Everolimus added to endocrine therapy provided modest but statistically significant PFS benefit (5.0 vs 4.3 months; HR 0.68) in ER+/HER2- advanced breast cancer post-CDK4/6 inhibitor progression, without demonstrable OS benefit, supporting selective use. Retrospective and non-randomised, so treatment-selection bias cannot be excluded.
2014 H Everolimus plus exemestane for hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: overall survival results from BOLERO-2† PIC2014 This is the final overall-survival report of BOLERO-2, the phase III double-blind trial (published primary analysis: BAS2012) in which postmenopausal women with hormone-receptor-positive, HER2-negative advanced breast cancer that had progressed on a nonsteroidal aromatase inhibitor received exemestane 25 mg/day plus either everolimus 10 mg/day or placebo. The primary endpoint, progression-free survival by local investigator, remained improved: median 7.8 vs 3.2 months (P < 0.0001), a 4.6-month gain. Overall survival, a key secondary endpoint, was not significantly improved: median 31.0 vs 26.6 months, hazard ratio 0.89 (95% CI 0.73-1.10), P = 0.14, at 410 deaths. Most patients went on to further treatment after the trial (84% vs 90%), with less chemotherapy in the everolimus arm (53% vs 63%), which may have diluted any survival difference. No new safety concerns were identified. Boundary: postmenopausal women with HR+/HER2- advanced breast cancer previously treated with a nonsteroidal aromatase inhibitor; comparator was exemestane plus placebo; the survival benefit of adding mTOR inhibition was not shown.
2012 H Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer (BOLERO-2) BAS2012 A phase 3 RCT (n=724) proving mTOR matters in a common cancer. Resistance to hormone therapy in breast cancer is associated with mTOR activation. Adding everolimus more than doubled progression-free survival (10.6 vs 4.1 months by central review) - leading to FDA approval. Main toxicity was stomatitis.
2026 A Anti-breast cancer effects of the Xingxiao Pill are associated with inhibition of the ErbB3/PI3K/AKT/mTOR pathway, modulation of amino acid metabolism, and promotion of apoptosis. ZHANG2026C Xingxiao Pill inhibited 4T1 breast cancer growth in vitro and in vivo by suppressing ErbB3/PI3K/AKT/mTOR signalling and reshaping amino acid metabolism; cinnamic acid and palmitic acid were identified as constituents that bind mTOR.
2023 A A bi-steric mTORC1-selective inhibitor overcomes drug resistance in breast cancer MEN2023 RMC-6272, a bi-steric molecule with >25-fold selectivity for mTORC1 over mTORC2, completely suppresses mTORC1 (hitting the rapamycin-resistant substrate 4E-BP1) and overcomes hormone- and CDK4/6-inhibitor resistance in breast cancer cell lines and PDX -- the preclinical basis for the RMC-5552 selective-inhibitor clinical program.
2026 M Transcriptional modulation of the PI3K/AKT/mTOR signaling pathway mediated by HPV16 E5, E6, and E7 oncogene expression in breast cancer. DEOLIVEIRA2026 In breast tumour tissue (48 of 92 patients with usable RNA), HPV16 oncogene expression was associated with higher PI3K and lower mTOR transcript levels. The design is correlational and measures mRNA only, so it does not show that the virus activates the mTOR pathway.
2026 M Collagen I promotes cancer cell survival via amino acid import and mTORC1/S6 activation NAZ2026 Collagen I drives alpha2beta1 integrin-dependent mTORC1/S6 activation and membrane localization of the LAT1-4F2hc amino acid transporter, sustaining essential amino acid supply and cancer cell survival in nutrient-poor, collagen-rich tumor stroma; LAT1-4F2hc is upregulated in basal-like breast/pancreatic tumors and correlates with poor prognosis.
2021 M G3BPs tether the TSC complex to lysosomes and suppress mTORC1 signaling PRE2021 Adds a physical brake upstream of mTORC1. G3BP1 and G3BP2, known until then as core stress-granule proteins, also sit on the cytoplasmic face of the lysosome and are what holds the TSC complex there; without them TSC cannot reach its target and mTORC1 becomes over-responsive to amino acids and insulin. Loss of G3BP1 reproduces TSC-like hyperactivity phenotypes: faster mTORC1-driven motility in breast cancer cells, with low G3BP1 correlating with worse patient outcome, and disturbed neuronal development in zebrafish. Relevant to the Atlas because it is a lysosomal tethering step that the canonical Rheb/TSC diagram does not show.

Related entities

mTORC1 5Everolimus 3PI3K 2Lysosome 1TSC1/TSC2 1ITGA2 (Integrin alpha-2)SLC7A5 (LAT1) 1mTOR 1ErbB3 (HER3)Akt/PKB 1Autophagy 1mTORC2 14E-BP1 1

Cite this page

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Barton, O. (2026). Breast cancer [Entity page]. In Oliver's mTOR Atlas [Data set]. https://mtor-atlas.org/disease/breast-cancer/ · Dataset DOI 10.5281/zenodo.22059963

@misc{atlas_disease_breast_cancer,
  author       = {Barton, Oliver},
  title        = {{Oliver's mTOR Atlas}: Breast cancer},
  howpublished = {Entity page in a data set},
  year         = {2026},
  url          = {https://mtor-atlas.org/disease/breast-cancer/},
  doi          = {10.5281/zenodo.22059963}
}
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