Hypothesis: pAkt/mTor and glycolysis are elevated in obese women prior to development of TNBC and are targeted by metformin-chemoprevention.
Methods/Results: Using proteomic-profiling and metabolic-imaging, we tested pAkt/mTor and metabolism in TNBC and matched normal breast tissue from lean (BMI<25) and obese (BMI>30) women. In obese women, pAkt/mTor and metabolism was activated in TNBC and normal tissue. In lean women only TNBC exhibited pAkt/mTor/metabolic-activation. We tested sequential biopsies from women who had normal biopsy and did or did not progress to TNBC within 12 months. In women that progressed, we observed activation of Akt/mTor/glycolysis/glucose-uptake in the "normal" biopsy.
Conclusions: pAkt/mTor/metabolic-signaling is activated in normal tissue prior to development of TNBC. Enrollment in our ALLIANCE-prevention trial is ongoing and will test the ability of metformin to target pAkt/mTor and metabolism.