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Aberrant activation of the EGFR pathway sometimes occurs by mutational activation of KRAS.
This finding may also be relevant in the context of colorectal cancer, which is frequently driven by mutational activation of the Wnt/β-catenin pathway.
Constitutive autocrine PDGF signaling can also be achieved by mutational activation of the genes encoding PDGF receptors or ligands.
Chemicals may influence the carcinogenic process by mutational activation of protooncogenes and/or inactivation of tumor suppressor genes.
The above mentioned observations in tumors (i.e. an induction of drug metabolism by mutational activation of β-catenin) gave rise to the hypothesis that, in normal healthy liver, physiological activation of the Wnt/β-catenin pathway in perivenous hepatocytes might induce the expression of enzymes related to drug metabolism (Hailfinger et al. 2006).
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This unintended outcome limits the efficacy of MET-disrupting monotherapy; further proliferation may also be driven by aberrant mutational activation of the RAS MEK pathway.
The question is whether other kinases play a role as well by mutational activation in glioblastoma.
KRAS is well established as an important downstream effector of the EGFR signaling pathway, and mutational activation of KRAS by further active downstream effectors like ERK induces drug resistance to EGFR antagonists (for example, cetuximab) [ 39].
Aberrant activation of the EGFR pathway in CRC could be caused by either EGFR overexpression or mutational activation of downstream elements of the EGFR pathway [7].
Less commonly, it could also result from the mutational activation of Ras oncogene that activates Akt through the PI-3K pathway (Datta et al, 1996; Liu et al, 1998) or from the mutational inactivation of the PTEN tumour-suppressor gene that normally inhibits Akt activity by dephosphorylating the PI-3,4,5 P 3 and PI-3,4 producedced by PI-3K (Stambolic et al, 1998; Ramaswamy et al, 1999).
It is possible, therefore, that hyperglycemia and other factors can initiate tumorigenesis by inducing replication stress that leads to mutational activation of oncogenes.
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