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. Author manuscript; available in PMC: 2014 Nov 1.
Published in final edited form as: Ann Surg Oncol. 2013 Jul 31;20(12):3862–3868. doi: 10.1245/s10434-013-3168-2

Figure 5. Schematic of potential combination treatment.

Figure 5

The phosphoinositide-3-kinase (PI3K)/Akt pathway is highly active in many tumor cells, including medullary thyroid cancer. The pathway is activated by one of many receptor tyrosine kinases (RTK). Akt is activated downstream of PI3K, and then can activate or inhibit multiple targets that lead to cell proliferation and inhibition of cell cycle arrest and apoptosis. Activation of RET (Rearranged during Transfection) can also activated PI3K. Certain compounds, including LY294002, Sorafenib, Sunitinib, Vandetanib, and MK-2206 (in black circles) effectively inhibit proteins in these pathways, and thus combinations of compounds that target different components could be tested. PTEN, Phosphate and Tensin Homolog; PIP2, phosphatidylinositol-3,4-diphosphate; PIP3, phosphatidylinositol-3,4,5-triphosphate.