WO2008049022A2 - Methods for detection of cancer - Google Patents

Abstract

A single nucleotide polymorphism in the AKT1 gene is disclosed. This single nucleotide polymorphism can be used to determine if subject can be treated (or is resistant to treatment) with a chemotherapeutic agent. The single nucleotide polymorphism can be used to detect a cancer or can be used to determine the prognosis of a cancer in a subject. Probes, primers and antibodies to detect the polymorphism are also disclosed.

Description

METHODS FOR DETECTION OF CANCER

CROSS REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application No: 60/852,782, filed October 18, 2006, which is incorporated by reference herein in its entirety.

FIELD

This application relates to cancer, specifically to the use of a single nucleotide polymorphism in the gene encoding v-akt murine thymoma viral oncogene homo log 1 (AKTl) to determine if a subject is susceptible to treatment with a chemotherapeutic agent.

BACKGROUND Cancer is an abnormal state in which uncontrolled proliferation of one or more cell populations interferes with normal biological functioning. The proliferative changes are usually accompanied by other changes in cellular properties, including reversion to a less differentiated, more developmentally primitive state. The in vitro correlate of cancer is called cellular transformation. Transformed cells generally display several or all of the following properties: spherical morphology, expression of fetal antigens, growth- factor independence, lack of contact inhibition, anchorage-independence, and growth to high density.

V-akt murine thymoma viral oncogene homo log 1 (AKTl) activity is elevated in a large number of human malignancies; it has been postulated that AKTl plays a central role in inducing a malignant phenotype by both promoting cell growth and decreasing apoptosis (Vivanco et ah, Nat Rev Cancer 2:489-501, 2002). AKTl is downstream of phosphatidylinositol 3-kinase (PBK) and is a critical node in this signal transduction pathway. The activation of AKTl by PBK is antagonized by the tumor suppressor PTEN (Maehama et ah, J Biol Chem 273:13375-8, 1998). Thus, it has been postulated that the increased AKTl activity that is observed in most human malignancies could be the result of (a) an increased AKTl expression, (b) increased PBK activity, or (c) decreased PTEN activity (Di Cristofano et al, Cell 100:387-90, 2000).

There is growing interest in the analysis of patterns of gene expression in cells, such as cancer cells and stem cells, using microarray technology. However, few studies have identified an individual polymorphism that is associated with the development of cancer. Thus, there is a need to identify new polymorphisms that can be used to determine the presence of a cancer, or to determine the prognosis of a subject with cancer.

SUMMARY

A method is provided herein for detecting a cancer, measuring the predisposition of a subject for developing a cancer, or determining the prognosis of the cancer. The method includes obtaining a biological sample from a subject; and screening the biological sample for the presence of a mutation in a nucleic acid encoding the Pleckstrin Homology (PH) domain of AKTl . In sone embodiments, the method includes detecting the presence of a mutation in a nucleic acid encoding the PH domain of AKTl, wherein the glutamic acid (E) at position 17 of the amino acid sequence of the PH domain of AKTl is replaced by a lysine (K).

Methods are provided herein to determine if a subject with cancer can be treated using an AKTl inhibitor. The method includes obtaining a biological sample from a subject; and screening the biological sample for the presence of a mutation in a nucleic acid encoding the Pleckstrin Homology (PH) domain of AKTl . The presence of a mutation in the nucleic acid encoding the PH domain of AKTl indicates that the subject is resistant to treatment with the AKTl inhibitor. The absence of a mutation in the PH domain of AKTl, indicates that the subject can be treated with the AKTl inhibitor. Both nucleotide and protein based assays are of use. In one example, the subject is a human.

Probes, primers and kits for the detection of a single nucleotide polymorphism in an AKTl gene are also provided herein. The foregoing and other features and advantages will become more apparent from the following detailed description of several embodiments, which proceeds with reference to the accompanying figures.

BRIEF DESCRIPTION OF THE FIGURES

Figs. 1A-1C are digital images of crystallographic models. Fig. IA is a digital image of a crystallographic model of apo wild-type AKTl PHD, showing that an ionic interaction between GIu 17 and Lys 14 (line) fills the binding pocket. The interatomic distances shown are in angstroms (A). Fig. IB is a digital image of a crystallographic model of AKTl E17K PHD apo, showing Lys 17 turned away from Lys 14. The interatomic distances shown are in angstroms (A). Fig. 1C is a digital image of a crystallographic model of AKTl E17K PHD, showing Lys 17 is involved in new hydrogen bonds (dashed lines) with a water molecule (sphere), interposed with the D6-hydroxyl group, and the D5-phosphate of Ins(l,3,4,5)P₄. Lys 17 also forms a new hydrogen bond with the hydroxyl of Tyr 18. The Dl- phosphate forms a hydrogen bond with the amide of Tyr 18, similar to the wild-type PHD. The interatomic distances shown are in angstroms (A).

Figs. 2A-2D are digital images of immunoblots. Fig. 2A is a set of digital images of immunoblots from cells trans fected with vector, Flag-tagged AKTl(WT), Flag-tagged AKT 1(E 17K) or Flag-tagged AKT1(R25C). The arrow represents the position of AKT. Fig. 2B is a bar graph showing the kinase activity of AKTl(WT), AKT 1(E 17K) or AKT1(R25C) immunoprecipitated with Flag antibody. Values were normalized against an IgG control and fold activity is expressed relative to AKTl(WT). Error bars, s.e.m. (n = 4, asterisk, P < 0.002 Tukey's HSD). Fig. 2C is a set of digital images of immunoprecipitated Flag-tagged protein (Flag-IP) was immunob lotted with total AKT antibody (upper panel). Whole-cell lysates of AKTl(WT), AKT1(E17K) and AKT1(R25C) were immunoblotted for P-AKT (S473 or T308), Flag or β-actin (lower panel). Fig. 2D is a set of digital images of immunoblots of P-AKT and phosphorylated FKHRLl (P-FKHRLl) in cells transfected with vector (lanes 1 and 4), AKT 1 (WT) (lanes 2 and 5) or AKT 1 (E 17K) (lanes 3 and 6). Cells were grown in 10% serum-supplemented media (lanes 1-3) or shifted into serum-free media for 24 hours, 48 hours after transfection (lanes 4-6). Figs. 3A-3B are digital images of immunoblots. Fig. 3A is a set of digital images demonstrating the localization of GFP-PHD in serum-starved GFP- PH(WT)-expressing and GFP-PH(E 17K)-expressing NIH 3T3 cells stimulated with PDGF. Cells were serum-starved before being stimulated with PDGF or treated with LY294002 (20 μM). Cells were imaged at X63 magnification; the arrows highlight membrane localization. Fig. 3B is a set of digital images of an immunoblot analysis of AKTl localization by biochemical cell fractionation of NIH 3T3 cells transfected with AKTl(WT) (lanes 1, 3, 5 and 7) or AKT1(E17K) (lanes 2, 4, 6 and 8). Eight or twenty-five micrograms of isolated cytoplasmic (cyto.) or membrane (mem.) proteins were loaded per lane, respectively.

Figs. 4A-4D are digital images of soft agar assays. Fig. 4A is a set of digital images of a monolayer background of Ratl cells transduced with vector alone or AKTl(WT), and representative foci transduced by AKT 1(E 17K) or Myr-AKTl retrovirus. Colonies were imaged (X4 magnification) approximately 15 days after becoming confluent. Fig. 4B is a set of representative digital images from parallel soft agar colony growth experiments with transduced cells shown in Fig. 4A. Colonies were imaged 29 days after initial infection. Fig. 4C is a set of digital images showing the detection of GFP expression in soft agar colonies (X4 magnification). Fig. 4D is a set of digital images of immunoblot analysis of isolated clones from foci formation plates (T308, arrow).

Figs. 5A-5C are a plot, a dot plot, and a digital image of a blood smear. Fig. 5 A is a plot of the timing of leukemia onset as determined by the appearance of discernible P-AKT(Ser 473)-GFP cells in blood of rescued lethally irradiated host animals. Myr-AKTl (n = 12, solid circles), AKT1(E17K) (n = 10, filled triangles), AKTl(WT) (n = 10, open squares) and mock transduction (n = 3, X) is shown. Fig. 5B is a set of dot plots of representative flow cytometry results from leukemic mice (AKT 1(E 17K) and Myr-AKTl) and non-leukemic mice (Mock and AKTl(WT)) after staining for P-AKT(Ser 473). Fig. 5C is a digital image of a stained blood smear from a representative AKT 1(E 17K) animal showing leukemic blasts (XlOO magnification).

Fig. 6 is a digital image of sequence chromatograms illustrating the AKTl 49G>A mutation. Screenshots from Sequencher 4.2 (GeneCodes) showing sequence chromatogram alignments for tumor samples found in Table 7. The panels show forward sequence reads (nucleotides 42-56 of SEQ ID NO:32 ). The sequences shown correspond to AKTl genomic sequences at the border of intron 1 and exon 2. Fig. 7 are a set of digital images of three separate breast tumor specimens from a tissue microarray slide stained with a PTEN monoclonal antibody. PTEN staining of tumor tissues is characterized as follows: Left, wild type PTEN expression in BR-T-85, tumor staining intensity of 3; Center, partial loss of PTEN expression in BR-T- 127 with decreased tumor staining intensity in relation to tissue fibroblasts marked by arrow; Right, complete loss of PTEN expression in BR-T-86.

Fig. 8 is a digital image of a surface representation of a crystallographic model showing that E17K alters the conformation of the AKTl PHD. Surface representation of the lipid binding pocket of wild-type (left panel) and E17K (right panel) AKTl PHD in the apo conformation. Figs. 9A-9C are Michaelis-Menten plots. Fig. 9A is a plot of Michaelis- wt E17K

Menten kinetics for ATP K generated with AKTl (closed squares) and AKTl wt E17K

(open circles). K values are 110 μM and 117 μM for AKTl and AKTl , respectively. Fig. 9B is a plot of Michaelis-Menten kinetics for biotinylated

Wt

Crosstide substrate. K obtained in the presence of 200 μM ATP for AKTl

E17K (closed squares) and AKTl (open circles). K M values are 4.6 μM and 4.9 μM for wt E17K

AKTl and AKTl respectively. Fig. 9C is a plot of a dose response curve of

E17K wt showing that AKTl is less sensitive to AKT- 1/2 inhibitor VIII than AKTl .

Wt

Percent inhibition IC50 curve of AKT- 1 /2 inhibitor VIII with AKT 1 (closed

E17K squares) and AKTl (open circles). Fig. 10 is a bar graph showing a quantitative analysis of biochemical cell fractionation. Data represent the fold increase in P-AKT T308 (gray), S473

E17K wt

(hatched) and FLAG (black) of AKTl levels compared to P-AKT . Error bars, s.e.m. (*p < 0.005, Dunnett's Procedure).

Fig. 11 is a set of digital images showing that infection of Rat 1 cells with

E17K AKT retrovirus induces foci formation. Confluent cultures of Rat 1 cells infected wt E17K with control vector, AKTl , AKTl or myr-AKTl retroviruses were stained with crystal violet. Cells were stained 15 days after becoming confluent. Photographs were taken at the same exposure and adjusted to the same brightness and contrast.

Fig. 12 is a schematic representation of the domain structure of the AKTl protein. The approximate position of the E17K mutation is shown. The protein domain image is from the National Center for Biological Information (see the NCBI website). The region of the protein representing the pleckstrin homology domain is from amino acids 8-108 of SEQ ID NO:1.

Figs. 13A-13B are digital images of mass spectra. Fig. 13A is a digital image of mass spectra obtained from a mass spectrometer showing the results of a SEQUENOM® IPLEX™ MASSARRAY® assay for the AKTl 49G>A mutation with a control sample having the normal G allele.

Fig. 13B is a digital image of mass spectra obtained from a mass spectrometer showing the results of a SEQUENOM® IPLEX™ MASSARRAY® assay for the AKTl 49G>A mutation with a sample having both the normal G allele and the mutant A allele.

SEQUENCE LISTING

The nucleic and amino acid sequences listed in the accompanying sequence listing are shown using standard letter abbreviations for nucleotide bases, and three letter code for amino acids, as defined in 37 CF. R. 1.822. Only one strand of each nucleic acid sequence is shown, but the complementary strand is understood as included by any reference to the displayed strand. In the accompanying sequence listing:

SEQ ID NO:1 is an exemplary amino acid sequence of human AKTl. SEQ ID NO:2 is an exemplary nucleic acid sequence of human AKTl.

SEQ ID NOs:3-28 are synthetic nucleic acid primers for the amplification of AKTl exons.

SEQ ID NOs:29 and 30 are synthetic nucleic acid primers. SEQ ID NO:31 is a synthetic nucleic acid IPEX™ extension primer. SEQ ID NO:32 is a portion of a genomic sequence encoding human AKTl , spanning the junction between AKTl intron 1 and exon 2. DETAILED DESCRIPTION

/. Terms

Unless otherwise noted, technical terms are used according to conventional usage. Definitions of common terms in molecular biology can be found in

Benjamin Lewin, Genes VII, published by Oxford University Press, 1999; Kendrew et al. (eds.), The Encyclopedia of Molecular Biology, published by Blackwell Science Ltd., 1994; and Robert A. Meyers (ed.), Molecular Biology and Biotechnology: a Comprehensive Desk Reference, published by VCH Publishers, Inc., 1995; and other similar references.

As used herein, the singular forms "a," "an," and "the," refer to both the singular as well as plural, unless the context clearly indicates otherwise. For example, the term "a probe" includes single or plural probes and can be considered equivalent to the phrase "at least one probe." As used herein, the term "comprises" means "includes." Thus, "comprising a probe" means "including a probe" without excluding other elements. Although many methods and materials similar or equivalent to those described herein can be used, particular suitable methods and materials are described below. In case of conflict, the present specification, including explanations of terms, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.

To facilitate review of the various embodiments of the invention, the following explanations of terms are provided:

AKT: A serine threonine kinase also known as protein kinase B. The three iso forms of mammalian homo log of v-akt murine thymoma viral oncongene (AKT) homolog are called AKTl, AKT2, and AKT3. All of the AKT isoforms have a pleckstrin homology domain that functions to bind these kinases to membrane surfaces through phosphatidylinositol trisphosphate (PIP₃). An exemplary amino acid sequence of protein kinase B (PKB), is shown in

GENBANK® Accession No. NP_005154 (October 8, 2006), herein incorporated by reference. A exemplary nucleic acid sequence encoding AKTl is provided as GENBANK® Accession No. NM_005163 (October 8, 2006), herein incorporated by reference. An exemplary amino acid sequence of an AKTl protein is set forth as SEQ ID NO:1, and an exemplary nucleic acid encoding an AKTl protein is set forth as SEQ ID NO:2. AKTl has been shown to regulate cell survival signals in response to growth factors, cytokines, and oncogenic Ras. AKTl becomes activated via the phosphoinositide-3-OH kinase (PBK) pathway and by other upstream kinases. AKT inhibits cell death pathways by directly phosphorylating and inactivating proteins involved in apoptosis, including Bad, procaspase 9, and members of the Forkhead transcription factor family.

AKTl includes a pleckstrin homology (PH) domain at the N-terminus. In human AKTl, the pleckstrin homology domain is located from amino acids 8 to 108, inclusive. Pleckstrin is the major substrate of protein kinase C in platelets. The PH domain has been shown to bind the beta/gamma subunit of heterotrimeric G proteins, phosphatidylinositol-4,5-bisphosphate (or PIP2), phosphorylated serine/threonine residues, and membranes. Disruption of the PH domain interferes with the membrane association of proteins. The PH domain of human AKTl is encoded by exon 1 (positions 1-46), exon 2 (positions 47-175), exon 3 (positions 176-287), and exon 4 (positions 288-435) of a human AK Tl gene. The AKT protein can be phosphorylated on serine 472 (Ser 473) and/or threonine 308 (Thr 308) An exemplary genomic sequence of the AKTl gene can be found GENBANK® Accession No. NC 000014 (available September 26, 2007) and is incorporated by reference herein in its entirety. A portion of the genomic sequence of the AKTl gene including the junction of inton 1 and exon 2 is reproduced herein as SEQ ID NO:32.

AKTl inhibitor: A molecule that inhibits the signaling of and AKTl protein, for example by inhibiting the kinase activity of AKTl

Adjuvant: A vehicle used to enhance antigenicity; such as a suspension of minerals (alum, aluminum hydroxide, aluminum phosphate) on which antigen is adsorbed; or water-in-oil emulsion in which antigen solution is emulsified in oil (MF-59, Freund's incomplete adjuvant), sometimes with the inclusion of killed mycobacteria (Freund's complete adjuvant) to further enhance antigenicity (inhibits degradation of antigen and/or causes influx of macrophages). Adjuvants also include immunostimulatory molecules, such as cytokines, costimulatory molecules, and for example, immunostimulatory DNA or RNA molecules, such as CpG oligonucleotides. Administration: The introduction of a composition into a subject by a chosen route. For example, if the chosen route is intravenous, the composition is administered by introducing the composition into a vein of the subject.

Amplification: To increase the number of copies of a nucleic acid molecule. The resulting amplification products are called "amplicons." Amplification of a nucleic acid molecule (such as a DNA or RNA molecule) refers to use of a technique that increases the number of copies of a nucleic acid molecule in a sample, for example the number of an AKTl nucleic acid, such as a mutant AKTl nucleic acid, for example an AKTl nucleic acid in which the nucleotide at position 49 of SEQ ID NO:2 is an A, or fragment thereof. An example of amplification is the polymerase chain reaction (PCR), in which a sample is contacted with a pair of oligonucleotide primers under conditions that allow for the hybridization of the primers to a nucleic acid template in the sample. The primers are extended under suitable conditions, dissociated from the template, re-annealed, extended, and dissociated to amplify the number of copies of the nucleic acid. This cycle can be repeated. The product of amplification can be characterized by such techniques as electrophoresis, restriction endonuclease cleavage patterns, oligonucleotide hybridization or ligation, and/or nucleic acid sequencing.

Other examples of in vitro amplification techniques include quantitative realtime PCR; reverse transcriptase PCR (RT-PCR); real-time PCR (rt PCR); real-time reverse transcriptase PCR (rt RT-PCR); nested PCR; strand displacement amplification (see U.S. Patent No. 5,744,311); transcription-free isothermal amplification (see U.S. Patent No. 6,033,881, repair chain reaction amplification (see WO 90/01069); ligase chain reaction amplification (see European patent publication EP-A-320 308); gap filling ligase chain reaction amplification (see U.S. Patent No. 5,427,930); coupled ligase detection and PCR (see U.S. Patent No.

6,027,889); and NASBA™ RNA transcription-free amplification (see U.S. Patent No. 6,025,134) amongst others. Animal: A living multicellular vertebrate organism, a category that includes, for example, mammals and birds. A "mammal" includes both human and non- human mammals. "Subject" includes both human and animal subjects.

Antibody: A polypeptide ligand including at least a light chain or heavy chain immunoglobulin variable region which specifically binds an epitope of an antigen, such a polypeptide including amino acids 8-108 of SEQ ID NO:1, wherein amino acid 17 is a lysine. The term "specifically binds" refers to, with respect to an antigen such as a polypeptide including amino acids 8- 108 of SEQ ID NO : 1 , wherein amino acid 17 is a lysine, the preferential association of an antibody or other ligand, in whole or part, with this polypeptide. A specific binding agent binds substantially only to a defined target, such as the polypeptide including amino acids 8-108 of SEQ ID NO:1, wherein amino acid 17 is a lysine. It is, of course, recognized that a minor degree of non-specific interaction may occur between a molecule, such as a specific binding agent, and a non-target polypeptide. Nevertheless, specific binding can be distinguished as mediated through specific recognition of the antigen. Although selectively reactive antibodies bind antigen, they can do so with low affinity. Specific binding typically results in greater than 2- fold, such as greater than 5-fold, greater than 10-fold, or greater than 100-fold increase in amount of bound antibody or other ligand (per unit time) to a polypeptide, such as a polypeptide including amino acids 8-108 of SEQ ID NO:1, wherein amino acid 17 is a lysine, as compared to a non-target polypeptide, such as a polypeptide including amino acids 8-108 of SEQ ID NO:1, wherein amino acid 17 is a glutamic acid.

A variety of immunoassay formats are appropriate for selecting antibodies specifically immunoreactive with a particular protein. For example, solid-phase ELISA immunoassays are routinely used to select monoclonal antibodies specifically immunoreactive with a protein. See Harlow & Lane, Antibodies, A Laboratory Manual, Cold Spring Harbor Publications, New York (1988), for a description of immunoassay formats and conditions that can be used to determine specific immunoreactivity.

Antibodies are composed of a heavy and a light chain, each of which has a variable region, termed the variable heavy (VH) region and the variable light (VL) region. Together, the VH region and the VL region are responsible for binding the antigen recognized by the antibody. This includes intact immunoglobulins and the variants and portions of them well known in the art, such as Fab' fragments, F(ab)'2 fragments, single chain Fv proteins ("scFv"), and disulfide stabilized Fv proteins ("dsFv"), that specifically bind the antigen. A scFv protein is a fusion protein in which a light chain variable region of an immunoglobulin and a heavy chain variable region of an immunoglobulin are bound by a linker, while in dsFvs, the chains have been mutated to introduce a disulfide bond to stabilize the association of the chains. The term also includes recombinant forms such as chimeric antibodies (for example, humanized murine antibodies), heteroconjugate antibodies (such as, bispecific antibodies). See also, Pierce Catalog and Handbook, 1994-1995 (Pierce Chemical Co., Rockford, IL); Kuby, Immunology, 3rd Ed., W.H. Freeman & Co., New York, 1997.

A "monoclonal antibody" is an antibody produced by a single clone of B-lymphocytes or by a cell into which the light and heavy chain genes of a single antibody have been transfected. Monoclonal antibodies are produced by methods known to those of skill in the art, for instance by making hybrid antibody- forming cells from a fusion of myeloma cells with immune spleen cells. These fused cells and their progeny are termed "hybridomas." Monoclonal antibodies include humanized monoclonal antibodies.

Antisense, Sense, and Antigene: Double-stranded DNA (dsDNA) has two strands, a 5 ' -> 3 ' strand, referred to as the plus strand, and a 3 ' -> 5 ' strand (the reverse complement), referred to as the minus strand. Because RNA polymerase adds nucleic acids in a 5' -> 3' direction, the minus strand of the DNA serves as the template for the RNA during transcription. Thus, the RNA formed will have a sequence complementary to the minus strand and identical to the plus strand (except that U is substituted for T).

Antisense molecules are molecules that are specifically hybridizable or specifically complementary to either RNA or the plus strand of DNA. Sense molecules are molecules that are specifically hybridizable or specifically complementary to the minus strand of DNA. Antigene molecules are either antisense or sense molecules directed to a dsDNA target. Binding or stable binding (of an oligonucleotide): An oligonucleotide binds or stably binds to a target nucleic acid if a sufficient amount of the oligonucleotide forms base pairs or is hybridized to its target nucleic acid, to permit detection of that binding. Binding can be detected by either physical or functional properties of the targetoligonucleotide complex. Binding between a target and an oligonucleotide can be detected by any procedure known to one skilled in the art, including both functional and physical binding assays.

Physical methods of detecting the binding of complementary strands of DNA or RNA are well known in the art, and include such methods as DNase I or chemical footprinting, gel shift and affinity cleavage assays, Northern blotting, dot blotting and light absorption detection procedures. For example, one method that is widely used, because it is so simple and reliable, involves observing a change in light absorption of a solution containing an oligonucleotide (or an analog) and a target nucleic acid at 220 to 300 nm as the temperature is slowly increased. If the oligonucleotide or analog has bound to its target, there is a sudden increase in absorption at a characteristic temperature as the oligonucleotide (or analog) and target disassociate from each other, or melt.

The binding between an oligomer and its target nucleic acid is frequently characterized by the temperature (T_m) at which 50% of the oligomer is melted from its target. A higher (T_m) means a stronger or more stable complex relative to a complex with a lower (T_m). cDNA (complementary DNA): A piece of DNA lacking internal, non- coding segments (introns) and transcriptional regulatory sequences. cDNA may also contain untranslated regions (UTRs) that are responsible for translational control in the corresponding RNA molecule. cDNA is usually synthesized in the laboratory by reverse transcription from messenger RNA (mRNA) extracted from cells, for example mRNA encoding an AKTl protein.

Complementarity and percentage complementarity: Molecules with complementary nucleic acids form a stable duplex or triplex when the strands bind, (hybridize), to each other by forming Watson-Crick, Hoogsteen or reverse

Hoogsteen base pairs. Stable binding occurs when an oligonucleotide remains detectably bound to a target nucleic acid sequence under the required conditions. Complementarity is the degree to which bases in one nucleic acid strand base pair with the bases in a second nucleic acid strand. Complementarity is conveniently described by percentage, such as the proportion of nucleotides that form base pairs between two strands or within a specific region or domain of two strands. For example, if 10 nucleotides of a 15-nucleotide oligonucleotide form base pairs with a targeted region of a DNA molecule, that oligonucleotide is said to have 66.67% complementarity to the region of DNA targeted.

A thorough treatment of the qualitative and quantitative considerations involved in establishing binding conditions that allow one skilled in the art to design appropriate oligonucleotides for use under the desired conditions is provided by Beltz et al. Methods Enzymol 100:266-285, 1983, and by Sambrook et al. (ed.), Molecular Cloning: A Laboratory Manual, 2nd ed., vol. 1-3, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY, 1989.

Chemotherapy: In cancer treatment, chemotherapy refers to the administration of one or more agents (chemotherapeutic agents) to kill or slow the reproduction of rapidly multiplying cells, such as tumor or cancer cells. In a particular example, chemotherapy refers to the administration of one or more agents to significantly reduce the number of tumor cells in the subject, such as by at least about 50%. "Chemotherapeutic agents" include any chemical agent with therapeutic usefulness in the treatment of cancer. Chemotherapeutic agents include kinase inhibitors, such as inhibitors of the serine/threonine kinase AKTl. Chemotherapeutic agents can be PI3 kinase inhibitors or PDPKl inhibitors. Specific, non-limiting examples of AKTl kinase inhibitors include triazole compounds, pyrazolylamine substituted quinazoline compounds, pyrazole compounds, indazole compounds, fused pyrimidyl pryrazole compounds, heterocyclic compounds and isoxazole compounds amongst others. Chemotherapeutic agents also include agents that are not kinase inhibitors. Examples of chemotherapeutic agents can be found for example in Slapak and Kufe, Principles of Cancer Therapy, Chapter 86 in Harrison's Principles of Internal Medicine, 14th edition; Perry et al., Chemotherapy, Ch. 17 in Abeloff, Clinical Oncology 2nd ed., 2000 Churchill Livingstone, Inc; Baltzer and Berkery. (eds): Oncology Pocket Guide to Chemotherapy, 2nd ed. St. Louis, Mosby-Year Book, 1995; Fischer Knobf, and Durivage (eds): The Cancer Chemotherapy Handbook, 4th ed. St. Louis, Mosby-Year Book, 1993). A chemotherapeutic agent of use in a subject, such as a AKTl kinase inhibitor, can decrease a sign or a symptom of a cancer, or can reduce, stop or reverse the progression, metastasis and/or growth of a cancer, and/or can reduce tumor mass. "Resistance" to a chemotherapeutic agent, such as an AKTl kinase inhibitor, means that a chemotherapeutic agent is not effective in reducing, stopping or reversing the progression, metastasis and/or growth of cancer, and/or does not affect tumor mass.

Contacting: Placement in direct physical association. Includes both in solid and liquid form. Contacting can occur in vitro with isolated cells or cell free extracts or in vivo by administering to a subject. "Administrating" to a subject includes topical, parenteral, oral, intravenous, intra-muscular, sub-cutaneous, inhalational, nasal, or intra-articular administration, among others.

Conditions of Serum Starvation: When cells are cultured in the absence of exogenous serum, such as fetal bovine serum.

Control: A reference standard. A control can be a known value indicative of basal activation for example phosphorylation or membrane associate or a control cell not contacted with an agent. A difference between a test sample and a control can be an increase or conversely a decrease. The difference can be a qualitative difference or a quantitative difference, for example a statistically significant difference. In some examples, a difference is an increase or decrease, relative to a control, of at least about 10%, such as at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, at least about 100%, at least about 150%, at least about 200%, at least about 250%, at least about 300%, at least about 350%, at least about 400%, at least about 500%, or greater then 500%.

DNA (deoxyribonucleic acid): DNA is a long chain polymer which comprises the genetic material of most living organisms (some viruses have genes comprising ribonucleic acid (RNA)). The repeating units in DNA polymers are four different nucleotides, each of which comprises one of the four bases, adenine, guanine, cytosine and thymine bound to a deoxyribose sugar to which a phosphate group is attached. Triplets of nucleotides (referred to as codons) code for each amino acid in a polypeptide, or for a stop signal. The term codon is also used for the corresponding (and complementary) sequences of three nucleotides in the mRNA into which the DNA sequence is transcribed.

Unless otherwise specified, any reference to a DNA molecule is intended to include the reverse complement of that DNA molecule. Except where single- strandedness is required by the text herein, DNA molecules, though written to depict only a single strand, encompass both strands of a double-stranded DNA molecule. Thus, a reference to the nucleic acid molecule that encodes AKTl, or a fragment thereof, encompasses both the sense strand and its reverse complement. Thus, for instance, it is appropriate to generate probes or primers from the reverse complement sequence of the disclosed nucleic acid molecules.

Degenerate variant: A polynucleotide encoding a polypeptide or an antibody that includes a sequence that is degenerate as a result of the genetic code. For example, a polynucleotide encoding AKTl includes a sequence that is degenerate as a result of the genetic code. There are 20 natural amino acids, most of which are specified by more than one codon. Therefore, all degenerate nucleotide sequences are included as long as the amino acid sequence of the AKTl polypeptide encoded by the nucleotide sequence is unchanged. Because of the degeneracy of the genetic code, a large number of functionally identical nucleic acids encode any given polypeptide. For instance, the codons CGU, CGC, CGA, CGG, AGA, and AGG all encode the amino acid arginine. Thus, at every position where an arginine is specified within a protein encoding sequence, the codon can be altered to any of the corresponding codons described without altering the encoded protein. Such nucleic acid variations are "silent variations," which are one species of conservative variations. Each nucleic acid sequence herein that encodes a polypeptide also describes every possible silent variation. One of skill will recognize that each codon in a nucleic acid (except AUG, which is ordinarily the only codon for methionine) can be modified to yield a functionally identical molecule by standard techniques. Accordingly, each "silent variation" of a nucleic acid which encodes a polypeptide is implicit in each described sequence.

Deletion: The removal of a sequence of a nucleic acid, the regions on either side of the removed sequence being joined together. In one example, during mRNA processing introns are deleted, such that the final mRNA sequence does not contain introns.

Detect: To determine if an agent (such as a signal, particular nucleotide, for example a nucleotide in an AKTl nucleic acid) is present or absent. In some examples, this can further include quantification.

Genomic target sequence: A sequence of nucleotides located in a particular region in the human genome that corresponds to one or more specific genetic abnormalities, such as a nucleotide polymorphism, a deletion, or an amplification. The target can be for instance a coding sequence; it can also be the non-coding strand that corresponds to a coding sequence. In one example, a genomic target sequence is the genomic sequence of an AKTl gene or portion thereof.

Haplotype: The ordered, linear combination of polymorphisms (e.g., single nucleotide polymorphisms, SNPs) in the sequence of each form of a gene (on individual chromosomes) that exists in a population.

Hybridization: Oligonucleotides and their analogs hybridize by hydrogen bonding, which includes Watson-Crick, Hoogsteen or reversed Hoogsteen hydrogen bonding, between complementary bases. Generally, nucleic acid consists of nitrogenous bases that are either pyrimidines (cytosine (C), uracil (U), and thymine (T)) or purines (adenine (A) and guanine (G)). These nitrogenous bases form hydrogen bonds between a pyrimidine and a purine, and the bonding of the pyrimidine to the purine is referred to as "base pairing." More specifically, A will hydrogen bond to T or U, and G will bond to C. "Complementary" refers to the base pairing that occurs between two distinct nucleic acid sequences or two distinct regions of the same nucleic acid sequence. For example, an oligonucleotide can be complementary to an AKTl encoding mRNA, an AKTl encoding DNA, or an AKTl -encoding dsDNA.

"Specifically hybridizable" and "specifically complementary" are terms that indicate a sufficient degree of complementarity such that stable and specific binding occurs between the oligonucleotide (or it's analog) and the DNA or RNA target.

The oligonucleotide or oligonucleotide analog need not be 100% complementary to its target sequence to be specifically hybridizable. An oligonucleotide or analog is specifically hybridizable when binding of the oligonucleotide or analog to the target DNA or RNA molecule interferes with the normal function of the target DNA or RNA, and there is a sufficient degree of complementarity to avoid non-specific binding of the oligonucleotide or analog to non-target sequences under conditions where specific binding is desired, for example under physiological conditions in the case of in vivo assays or systems. Such binding is referred to as specific hybridization. In one example, an oligonucleotide is specifically hybridizable to DNA or RNA encoding an AKTl polypeptide wherein amino acid 17 is a lysine wherein it will not hybridize with a DNA or RNA encoding an AKTl polypeptide wherein amino acid 17 is a glutamic acid. In another example, an oligonucleotide is specifically hybridizable to DNA or RNA encoding an AKTl polypeptide wherein amino acid 17 is a glutamic acid wherein it will not hybridize with a DNA or RNA encoding an AKTl polypeptide wherein amino acid 17 is a lysine.

Hybridization conditions resulting in particular degrees of stringency will vary depending upon the nature of the hybridization method of choice and the composition and length of the hybridizing nucleic acid sequences. Generally, the temperature of hybridization and the ionic strength (especially the Na⁺ concentration) of the hybridization buffer will determine the stringency of hybridization, though waste times also influence stringency. Calculations regarding hybridization conditions required for attaining particular degrees of stringency are discussed by Sambrook et al. (ed.), Molecular Cloning: A Laboratory Manual, 2nd ed., vol. 1-3, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY, 1989, chapters 9 and 11.

The following is an exemplary set of hybridization conditions and is not limiting:

Very High Stringency (detects sequences that share at least 90% identity) Hybridization: 5x SSC at 65⁰C for 16 hours

Wash twice: 2x SSC at room temperature (RT) for 15 minutes each

Wash twice: 0.5x SSC at 65⁰C for 20 minutes each

High Stringency (detects sequences that share at least 80% identity) Hybridization: 5x-6x SSC at 65°C-70°C for 16-20 hours Wash twice: 2x SSC at RT for 5-20 minutes each

Wash twice: Ix SSC at 55°C-70°C for 30 minutes each

Low Stringency (detects sequences that share at least 50% identity) Hybridization: 6x SSC at RT to 55⁰C for 16-20 hours

Wash at least twice: 2x-3x SSC at RT to 55⁰C for 20-30 minutes each.

Isolated: An "isolated" biological component (such as a nucleic acid molecule, protein or organelle) has been substantially separated or purified away from other biological components in the cell of the organism in which the component naturally occurs, i.e., other chromosomal and extra-chromosomal DNA and RNA, proteins and organelles. Nucleic acids and proteins that have been "isolated" include nucleic acids and proteins purified by standard purification methods. The term also embraces nucleic acids and proteins prepared by recombinant expression in a host cell as well as chemically synthesized nucleic acids.

Inhibiting or treating a disease: Inhibiting the full development of a disease or condition, for example, in a subject who is at risk for a disease such cancer, or combinations thereof. "Treatment" refers to a therapeutic intervention that ameliorates a sign or symptom of a disease or pathological condition after it has begun to develop. The term "ameliorating," with reference to a disease or pathological condition, refers to any observable beneficial effect of the treatment. The beneficial effect can be evidenced, for example, by a delayed onset of clinical symptoms of the disease in a susceptible subject, a reduction in severity of some or all clinical symptoms of the disease, a slower progression of the disease, a reduction in the number of metastases, an improvement in the overall health or well-being of the subject, or by other clinical or physiological parameters associated with a particular disease. A "prophylactic" treatment is a treatment administered to a subject who does not exhibit signs of a disease or exhibits only early signs for the purpose of decreasing the risk of developing pathology. Inhibit: To reduce to a measurable extent. For example to reduce enzymatic activity. Kinase: An enzyme that catalyzes the transfer of a phosphate group from one molecule to another. A "serine threonine kinase," such as AKTl transfers phosphate groups to a hydroxyl group of serine and/or threonine in a polypeptide. Label: An agent capable of detection, for example by spectrophotometry, flow cytometry, or microscopy. For example, a label can be attached to a nucleotide, thereby permitting detection of the nucleotide, such as detection of the nucleic acid molecule of which the nucleotide is a part, such as an AKTl specific probe or primer. Labels can also be attached to antibodies. Examples of labels include, but are not limited to, radioactive isotopes, enzyme substrates, co-factors, ligands, chemiluminescent agents, fluorophores, haptens, enzymes, and combinations thereof. Methods for labeling and guidance in the choice of labels appropriate for various purposes are discussed for example in Sambrook et al. (Molecular Cloning: A Laboratory Manual, Cold Spring Harbor, New York, 1989) and Ausubel et al. (In Current Protocols in Molecular Biology, John Wiley & Sons, New York, 1998). Nucleotide: "Nucleotide" includes, but is not limited to, a monomer that includes a base linked to a sugar, such as a pyrimidine, purine or synthetic analogs thereof, or a base linked to an amino acid, as in a peptide nucleic acid (PNA). A nucleotide is one monomer in a polynucleotide. A nucleotide sequence refers to the sequence of bases in a polynucleotide. Oligonucleotide: An oligonucleotide is a plurality of joined nucleotides joined by native phosphodiester bonds, between about 6 and about 300 nucleotides in length. An oligonucleotide analog refers to moieties that function similarly to oligonucleotides but have non-naturally occurring portions. For example, oligonucleotide analogs can contain non-naturally occurring portions, such as altered sugar moieties or inter-sugar linkages, such as a phosphorothioate oligodeoxynucleotide. Functional analogs of naturally occurring polynucleotides can bind to RNA or DNA, and include peptide nucleic acid (PNA) molecules.

Particular oligonucleotides and oligonucleotide analogs can include linear sequences up to about 200 nucleotides in length, for example a sequence (such as DNA or RNA) that is at least 6 bases, for example at least 8, 10, 15, 20, 25, 30, 35, 40, 45, 50, 100 or even 200 bases long, or from about 6 to about 50 bases, for example about 10-25 bases, such as 12, 15 or 20 bases. Open reading frame: A series of nucleotide triplets (codons) coding for amino acids without any internal termination codons.

Pharmaceutically acceptable carriers: The pharmaceutically acceptable carriers of use are conventional. Remington 's Pharmaceutical Sciences, by E.W. Martin, Mack Publishing Co., Easton, PA, 15th Edition, 1975, describes compositions and formulations suitable for pharmaceutical delivery of the compositions disclosed herein.

In general, the nature of the carrier will depend on the particular mode of administration being employed. For instance, parenteral formulations usually comprise injectable fluids that include pharmaceutically and physiologically acceptable fluids such as water, physiological saline, balanced salt solutions, aqueous dextrose, glycerol or the like as a vehicle. For solid compositions (such as powder, pill, tablet, or capsule forms), conventional non-toxic solid carriers can include, for example, pharmaceutical grades of mannitol, lactose, starch, or magnesium stearate. In addition to biologically neutral carriers, pharmaceutical compositions to be administered can contain minor amounts of non-toxic auxiliary substances, such as wetting or emulsifying agents, preservatives, and pH buffering agents and the like, for example sodium acetate or sorbitan monolaurate.

Polymerizing agent: A compound capable of reacting monomer molecules (such as nucleotides) together in a chemical reaction to form linear chains or a three- dimensional network of polymer chains. A particular example of a polymerizing agent is polymerase, an enzyme, which catalyzes the 5' to 3' elongation of a primer strand complementary to a nucleic acid template. Examples of polymerases that can be used to amplify a nucleic acid molecule include, but are not limited to the E. coli DNA polymerase I, specifically the Klenow fragment which has 3' to 5' exonuclease activity, Taq polymerase, reverse transcriptase (such as HIV-I RT), E. coli RNA polymerase, and wheat germ RNA polymerase II.

The choice of polymerase is dependent on the nucleic acid to be amplified. If the template is a single-stranded DNA molecule, a DNA-directed DNA or RNA polymerase can be used; if the template is a single-stranded RNA molecule, then a reverse transcriptase (such as an RNA-directed DNA polymerase) can be used. Polymorphism: Variant in a nucleic acid sequence of a gene. Polymorphisms can be those variations (nucleotide sequence differences) that, while having a different nucleotide sequence, produce functionally equivalent gene products, such as those variations generally found between individuals, different ethnic groups, geographic locations. The term polymorphism also encompasses variations that produce gene products with altered function; these variants in the gene sequence that lead to gene products that are not functionally equivalent. This term also encompasses variations that produce no gene product, an inactive gene product, or increased or decreased gene product. The term polymorphism may be used interchangeably with allele or mutation, unless context clearly dictates otherwise.

A single nucleotide polymorphism, or SNP, is a DNA sequence variation occurring when a single nucleotide in the genome differs between members of a species (or between paired chromosomes in an individual). Polymorphisms can be referred to, for instance, by the nucleotide position at which the variation exists, by the change in amino acid sequence caused by the nucleotide variation, or by a change in some other characteristic of the nucleic acid molecule that is linked to the variation (for example, an alteration of a secondary structure such as a stem-loop, or an alteration of the binding affinity of the nucleic acid for associated molecules, such as transcriptional activators, transcriptional repressors, and so forth). By way of example, a polymorphism in the human AKTl gene can be referred to by its location in the nucleic acid (for example, 49 based on the numerical position of the variant residue in SEQ ID NO:2) or by its effect on the protein sequence (for example, the presence of a lysine at position 17 in SEQ ID NO:1).

Polypeptide: Any chain of amino acids, regardless of length or post- translational modification (such as glycosylation, methylation, ubiquitination, phosphorylation, or the like). In one embodiment, a polypeptide is an AKTl polypeptide. A "residue" refers to an amino acid or amino acid mimetic incorporated in a polypeptide by an amide bond or amide bond mimetic. A polypeptide has an amino terminal (N-terminal) end and a carboxy terminal (C- terminal) end. "Polypeptide" is used interchangeably with peptide or protein, and is used to refer to a polymer of amino acid residues.

Phosphorylation: The addition of a phosphate to a protein, typically by a kinase by transferring a phosphate group from adenosine triphosphate (ATP).. Measurable phosphorylation of a polypeptide, such as a protein can be quantified using well known assays. This can be done by measuring the incorporation of a radioactive isotope of phosphorous into a test protein, for example the incorporation of [³²P] from the γ phosphate of [γ-³²P]ATP. Phosphorylation can also be measured with antibodies that preferentially bind the phosphorylated form of a protein, for example an AKTl protein phosphorylated at serine 472 (Ser 473) and/or threonine 308 (Thr 308)

Probes and primers: A probe comprises an isolated nucleic acid capable of hybridizing to a target nucleic acid (such as an AKTl nucleic acid molecule). A detectable label or reporter molecule can be attached to a probe. Typical labels include radioactive isotopes, enzyme substrates, co-factors, ligands, chemiluminescent or fluorescent agents, haptens, and enzymes. Methods for labeling and guidance in the choice of labels appropriate for various purposes are discussed, for example in Sambrook et al. (In Molecular Cloning: A Laboratory Manual, CSHL, New York, 1989) and Ausubel et al. (In Current Protocols in Molecular Biology, John Wiley & Sons, New York, 1998).

In a particular example, a probe includes at least one fluorophore, such as an acceptor fluorophore or donor fluorophore. For example, a fluorophore can be attached at the 5'- or 3 '-end of the probe. In specific examples, the fluorophore is attached to the base at the 5 '-end of the probe, the base at its 3 '-end, the phosphate group at its 5'-end or a modified base, such as a T internal to the probe.

Probes are generally at least 12 nucleotides in length, such as at least 12 , at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, least 20, at least 21, at least 22, at least 23, at least 24, at least 25, at least 26, at least 27, at least 28, at least 29, at least 30, or more contiguous nucleotides complementary to the target nucleic acid molecule, such as 12-30 nucleotides, 15-30 nucleotides, 20-30 nucleotides, or 12-29 nucleotides. Primers are short nucleic acid molecules, for instance DNA oligonucleotides 10 nucleotides or more in length, which can be annealed to a complementary target nucleic acid molecule by nucleic acid hybridization to form a hybrid between the primer and the target nucleic acid strand. A primer can be extended along the target nucleic acid molecule by a polymerase enzyme. Therefore, primers can be used to amplify a target nucleic acid molecule (such as a portion of a AKTl nucleic acid molecule).

The specificity of a primer increases with its length. Thus, for example, a primer that includes 30 consecutive nucleotides will anneal to a target sequence with a higher specificity than a corresponding primer of only 15 nucleotides. Thus, to obtain greater specificity, probes and primers can be selected that include at least 15, 20, 25,

30, 35, 40, 45, 50 or more consecutive nucleotides. In particular examples, a primer is at least 15 nucleotides in length, such as at least 15 contiguous nucleotides complementary to a target nucleic acid molecule. Particular lengths of primers that can be used to practice the methods of the present disclosure (for example, to amplify a region of a AKTl nucleic acid molecule) include primers having at least 15, at least 16, at least 17, at least 18, at least 19, at least 20, at least 21, at least 22, at least 23, at least 24, at least 25, at least 26, at least 27, at least 28, at least 29, at least 30, at least

31, at least 32, at least 33, at least 34, at least 35, at least 36, at least 37, at least 38, at least 39, at least 40, at least 45, at least 50, or more contiguous nucleotides complementary to the target nucleic acid molecule to be amplified, such as a primer of

15-50 nucleotides, 20-50 nucleotides, or 15-30 nucleotides.

Primer pairs can be used for amplification of a nucleic acid sequence, for example, by PCR, real-time PCR, or other nucleic-acid amplification methods known in the art. An "upstream" or "forward" primer is a primer 5' to a reference point on a nucleic acid sequence. A "downstream" or "reverse" primer is a primer 3' to a reference point on a nucleic acid sequence. In general, at least one forward and one reverse primer are included in an amplification reaction.

Nucleic acid probes and primers can be readily prepared based on the nucleic acid molecules provided herein. It is also appropriate to generate probes and primers based on fragments or portions of these disclosed nucleic acid molecules, for instance regions that encompass the identified polymorphism at position 49 in a human AKTl sequence or the cite of mutation in the genomic nucleic acid sequence of AKTl or a sub-sequence thereof, such as SEQ ID NO:32.

PCR primer pairs can be derived from a known sequence (such as the AKTl nucleic acid molecules as set forth in SEQ ID NO:2, and/or SEQ ID NO:32) for example, by using computer programs intended for that purpose such as Primer (Version 0.5, © 1991, Whitehead Institute for Biomedical Research, Cambridge, MA) or PRIMER EXPRESS® Software (Applied Biosystems, AB, Foster City, CA).

Prognosis: The probable course or outcome of a disease process. In several examples, the prognosis of a subject with cancer can indicate the likelihood of survival and/or the likelihood of metastasis. The prognosis of a subject with cancer can indicate the likelihood that the subject will survive for a period of time, such as about one, about two, about three, about four, about five or about ten years. The prognosis of a subject with cancer can also indicate the likelihood of a cure, of the likelihood that the subject will remain disease-free following treatment for a period of time, such as about one, about two, about three, about four, about five or about ten years.

Purified: The term "purified" does not require absolute purity; rather, it is intended as a relative term. Thus, for example, a purified protein preparation is one in which the protein referred to is more pure than the protein in its natural environment within a cell or within a production reaction chamber (as appropriate). Recombinant: A recombinant nucleic acid is one that has a sequence that is not naturally occurring or has a sequence that is made by an artificial combination of two otherwise separated segments of sequence. This artificial combination can be accomplished by chemical synthesis or, more commonly, by the artificial manipulation of isolated segments of nucleic acids, such as by genetic engineering techniques.

Sample: A sample, such as a biological sample, is a sample obtained from a plant or animal subject. As used herein, biological samples include all clinical samples useful for detection of AKTl in subjects, including, but not limited to, cells, tissues, and bodily fluids, such as: blood; derivatives and fractions of blood, such as serum; extracted galls; biopsied or surgically removed tissue, including tissues that are, for example, unfixed, frozen, fixed in formalin and/or embedded in paraffin; tears; milk; skin scrapes; surface washings; urine; sputum; cerebrospinal fluid; prostate fluid; pus; or bone marrow aspirates. In particular embodiments, the biological sample is obtained from a subject, such as in the form of blood or serum. Sequence identity/similarity: The identity/similarity between two or more nucleic acid sequences, or two or more amino acid sequences, is expressed in terms of the identity or similarity between the sequences. Sequence identity can be measured in terms of percentage identity; the higher the percentage, the more identical the sequences are. Homo logs or orthologs of nucleic acid or amino acid sequences possess a relatively high degree of sequence identity/similarity when aligned using standard methods.

Methods of alignment of sequences for comparison are well known in the art. Various programs and alignment algorithms are described in: Smith & Waterman, Adv. Appl. Math. 2:482, 1981; Needleman & Wunsch, J. MoI. Biol. 48:443, 1970; Pearson & Lipman, Proc. Natl. Acad. Sci. USA 85:2444, 1988; Higgins & Sharp, Gene, 73:237-44, 1988; Higgins & Sharp, CABIOS 5:151-3, 1989; Corpet et al, Nuc. Acids Res. 16:10881-90, 1988; Huang et al. Computer Appls. in the Biosciences 8, 155-65, 1992; and Pearson et al, Meth. MoI. Bio. 24:307-31, 1994. Altschul et al, J. MoI Biol. 215:403-10, 1990, presents a detailed consideration of sequence alignment methods and homology calculations.

The NCBI Basic Local Alignment Search Tool (BLAST) (Altschul et al, J. MoI Biol. 215:403-10, 1990) is available from several sources, including the National Center for Biological Information (NCBI, National Library of Medicine, Building 38 A, Room 8N805, Bethesda, MD 20894) and on the Internet, for use in connection with the sequence analysis programs blastp, blastn, blastx, tblastn, and tblastx. Blastn is used to compare nucleic acid sequences, while blastp is used to compare amino acid sequences. Additional information can be found at the NCBI web site.

Homo logs and variants of an AKTl protein are typically characterized by possession of at least 50% sequence identity counted over the full length alignment with the amino acid sequence of a native protein using the NCBI Blast 2.0, gapped blastp set to default parameters. For comparisons of amino acid sequences of greater than about 30 amino acids, the Blast 2 sequences function is employed using the default BLOSUM62 matrix set to default parameters, (gap existence cost of 11, and a per residue gap cost of 1). When aligning short peptides (fewer than around 30 amino acids), the alignment should be performed using the Blast 2 sequences function, employing the PAM30 matrix set to default parameters (open gap 9, extension gap 1 penalties). Proteins with even greater similarity to the reference sequences will show increasing percentage identities when assessed by this method, such as at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% sequence identity. When less than the entire sequence is being compared for sequence identity, homo logs and variants will typically possess at least 75% sequence identity over short windows of 10-20 amino acids, and may possess sequence identities of at least 85% or at least 90% at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% depending on their similarity to the reference sequence. Methods for determining sequence identity over such short windows are described at the NCBI website. One of skill in the art will appreciate that these sequence identity ranges are provided for guidance only; it is entirely possible that strongly significant homo logs could be obtained that fall outside of the ranges provided.

Once aligned, the number of matches is determined by counting the number of positions where an identical nucleotide or amino acid residue is present in both sequences. The percent sequence identity is determined by dividing the number of matches either by the length of the sequence set forth in the identified sequence, or by an articulated length (such as 100 consecutive nucleotides or amino acid residues from a sequence set forth in an identified sequence), followed by multi/?/ying the resulting value by 100. For example, a nucleic acid sequence that has 1166 matches when aligned with a test sequence having 1554 nucleotides is 75.0 percent identical to the test sequence (1166÷1554* 100=75.0). The percent sequence identity value is rounded to the nearest tenth. For example, 75.11, 75.12, 75.13, and 75.14 are rounded down to 75.1, while 75.15, 75.16, 75.17, 75.18, and 75.19 are rounded up to 75.2. The length value will always be an integer. One indication that two nucleic acid molecules are closely related is that the two molecules hybridize to each other under stringent conditions. Sub-sequence: A fraction of a larger nucleic acid sequence. For example, a sub-sequence of SEQ ID NO:2 is any sequence contained within the sequence of SEQ ID NO:2

Target nucleic acid molecule: A nucleic acid molecule whose detection, quantitation, qualitative detection, or a combination thereof, is intended. The nucleic acid molecule need not be in a purified form. Various other nucleic acid molecules can also be present with the target nucleic acid molecule. For example, the target nucleic acid molecule can be a specific nucleic acid molecule (which can include RNA such as AKTl RNA, or DNA, such as AKTl DNA, for example AKTl cDNA or AKTl genomic DNA and/or replicated, such as amplified AKTl DNA), the amplification and/or detection of which is intended. Purification or isolation of the target nucleic acid molecule, if needed, can be conducted by methods known to those in the art, such as by using a commercially available purification kit or the like. In one example, a target nucleic molecule is an AKTl nucleic acid sequence.

Therapeutically effective amount: The quantity of a composition sufficient to achieve a desired effect in a subject being treated. For instance, this can be the amount necessary to inhibit the progression of a cancer or to measurably alter outward symptoms of a cancer. When administered to a subject, a dosage will generally be used that will achieve target tissue concentrations that has been shown to achieve in vitro inhibition of or to measurably alter outward symptoms of a cancer.

Transformed: A transformed cell is a cell into which has been introduced a nucleic acid molecule by molecular biology techniques. As used herein, the term transformation encompasses all techniques by which a nucleic acid molecule might be introduced into such a cell, including transfection with viral vectors, transformation with plasmid vectors, and introduction of naked DNA by electroporation, lipofection, and particle gun acceleration.

Tumor or cancer: The product of neoplasia is a neoplasm (a tumor or cancer), which is an abnormal growth of tissue that results from excessive cell division. A tumor that does not metastasize is referred to as "benign." A tumor that invades the surrounding tissue and/or can metastasize is referred to as "malignant." Neoplasia is one example of a proliferative disorder.

Examples of hematological cancers include leukemias, including acute leukemias (such as acute lymphocytic leukemia, acute myelocytic leukemia, acute myelogenous leukemia and myeloblastic, promyelocytic, myelomonocytic, monocytic and erythroleukemia), chronic leukemias (such as chronic myelocytic (granulocytic) leukemia, chronic myelogenous leukemia, and chronic lymphocytic leukemia), polycythemia vera, lymphoma, Hodgkin's disease, non-Hodgkin's lymphoma (indolent and high grade forms), multiple myeloma, Waldenstrom's macroglobulinemia, heavy chain disease, myelodysplastic syndrome, and myelodysplasia.

Examples of solid cancers, such as sarcomas and carcinomas, include fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, and other sarcomas, synovioma, mesothelioma, Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, lymphoid malignancy, pancreatic cancer, breast cancer, lung cancers, ovarian cancer, prostate cancer, hepatocellular carcinoma, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary adenocarcinomas, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile duct carcinoma, choriocarcinoma, Wilms' tumor, cervical cancer, testicular tumor, bladder carcinoma, and CNS tumors (such as a glioma, astrocytoma, medulloblastoma, craniopharyogioma, ependymoma, pinealoma, hemangioblastoma, acoustic neuroma, oligodendroglioma, menangioma, melanoma, neuroblastoma and retinoblastoma). Specific non- limiting examples of cancers are breast, colorectal and ovarian cancers.

Vector: A nucleic acid molecule as introduced into a host cell, thereby producing a transformed host cell. A vector may include nucleic acid sequences that permit it to replicate in a host cell, such as an origin of replication. A vector may also include one or more selectable marker genes and other genetic elements known in the art. Wild- type (WT): The naturally occurring sequence in a subject not affected with a specific disease or disorder. Thus, a wild-type AKTl amino acid sequence is the amino acid sequence of AKTl in individuals without a cancer. A wild-type AKTl nucleic acid sequence is the nucleic acid sequence encoding AKTl in individuals without the cancer.

Detection of AKTl Polymorphism

Nucleotide polymorphisms in the AKTl gene are disclosed herein. These single nucleotide polymorphism can be used to determine if a subject can be treated (or is resistant to treatment) with a chemotherapeutic agent. The single nucleotide polymorphisms can be used to detect a cancer or can be used to determine the prognosis of a cancer in a subject. Probes, primers and antibodies to detect the polymorphism are also disclosed. In several embodiments, the single nucleotide polymorphism is in the AKTl pleckstrin homology (PH) domain. In particular embodiments, the single nucleotide polymorphism is at amino acid position 17 in the AKTl amino acid sequence set forth as SEQ ID NO:1. As disclseod herein, the presence of a mutation at position 17 in the AKTl amino acid sequence set forth as SEQ ID NO:1 results in a mislocalization of AKTl

Methods are provided herein to determine if a subject with cancer can be treated using an AKTl inhibitor. The method includes obtaining a biological sample from a subject and screening the biological sample for the presence of a mutation in a nucleic acid encoding the Pleckstrin Homology (PH) domain of AKTl . The absence of a mutation in the PH domain of AKTl polypeptide, such that the wild- type PH domain is present in AKTl polypeptide, indicates that the subject can be treated with the AKTl inhibitor. The presence of a mutation in the nucleic acid encoding the PH domain of AKTl indicates that the subject is resistant to the AKTl inhibitor. The presence of a mutation in the nucleic encoding the PH domain of AKTl can also indicate that a subject is resistant to treatment with an epidermal growth factor receptor antagonist, a platelet derived growth factor receptor (PDF) antagonist, her2/neu antagonist, a mammalian target of rapamycin (mTOR) inhibitor, Toll-like receptor inhibitor, a nuclear factor (NF)κβ inhibitor, or a PB kinase inhibitor. Methods are provided for determining if a subject with cancer would benefit from treatment with an agent that inhibits the localization of a v-akt murine thymoma viral oncogene homo log 1 (AKTl) polypeptide to the plasma membrane of a cell or inhibits the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308. The method includes obtaining a sample from the subject and screening the biological sample for the presence of a mutation in a nucleic acid encoding the Pleckstrin Homology (PH) domain of AKTl. The absence of a mutation in the PH domain of AKTl polypeptide, such that the wild-type PH domain is present in AKTl polypeptide, indicates that the subject likely will not benefit from treatment with an inhibitor of AKTl localization AKTl to the plasma membrane an inhibitor of the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308. The presence of a mutation in the PH domain of AKTl polypeptide, such that the wild-type PH domain is present in AKTl polypeptide, indicates that the subject likely will benefit from treatment with an inhibitor of AKTl localization AKTl to the plasma membrane an inhibitor of the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308.

A method is provided herein for detecting a cancer, measuring the predisposition of a subject for developing a cancer, or determining the prognosis of the cancer. The method includes obtaining a biological sample from a subject; and screening the biological sample for the presence of a mutation in a nucleic acid encoding the Pleckstrin Homology (PH) domain of AKTl. The absence of a mutation in the PH domain of AKTl polypeptide, such that the wild-type PH domain is present in AKTl polypeptide, indicates that the subject does not have cancer, is not predisposed to developing cancer, or has a good prognosis. The presence of a mutation in the nucleic acid encoding the PH domain of AKT 1 indicates that the subject has cancer is predisposed to developing cancer, or has a poor prognosis.

The subject can be any mammalian subject, including, but not limited to, mammals such as a dog, cat, rabbit, cow, bird, rat, horse, pig, or monkey. The subject can be any subject of interest, including a human subject.

In humans, in several examples, the methods disclosed herein includes detecting the presence of a mutation in a nucleic acid encoding the PH domain of AKTl, wherein the glutaminic acid (E) at position 17 of the amino acid sequence of the wild-type PH domain of wild-type AKTl is replaced by a lysine (K). An exemplary amino acid sequence of human AKTl is set forth below:

MSDVAIVKEGWLHKRGXYIKTWRPRYFLLKNDGTFIGYKERPQDVDQREAPLNNFS VAQCQLMKTERPRPNTFIIRCLQWTTVIERTFHVETPEEREEWTTAIQTVADGLKK

QEEEEMDFRSGSPSDNSGAEEMEVSLAKPKHRVTMNEFEYLKLLGKGTFGKVILVK

EKATGRYYAMKILKKEVIVAKDEVAHTLTENRVLQNSRHPFLTALKYSFQTHDRLC

FVMEYANGGELFFHLSRERVFSEDRARFYGAEIVSALDYLHSEKNVVYRDLKLENL

MLDKDGHIKITDFGLCKEGIKDGATMKTFCGTPEYLAPEVLEDNDYGRAVDWWGLG VVMYEMMCGRLPFYNQDHEKLFELILMEEIRFPRTLGPEAKSLLSGLLKKDPKQRL

GGGSEDAKEIMQHRFFAGIVWQHVYEKKLSPPFKPQVTSETDTRYFDEEFTAQMIT

ITPPDQDDSMECVDSERRPHFPQFSYSASGTA (SEQ ID NO: 1, wherein X is K or E)

The PH domain of SEQ ID NO: 1 is located from about amino acids 8 to about amino acids 108. In the wild-type human AKTl amino acid sequence, the X at position 17 is a glutamic acid (E). It should be noted that wherein amino acids are referred to herein with respect to SEQ ID NO: 1 the numeration relates to the position of the amino acid in the full-length polypeptide. Thus, a wild-type peptide including the PH domain of SEQ ID NO:1, wherein amino acid 17 is a glutamic acid refers to the glutamic acid at position 17 of the full length protein (SEQ ID NO: 1) shown above. Similarly, a mutant peptide including the PH domain of SEQ ID NO:1, wherein amino acid 17 is a lysine refers to the lysine at position 17 of the full length protein (SEQ ID NO:1) shown above. In several embodiments, detection of a PH domain, such as amino acids 8-

108 of AKTl protein with a lysine at position 17 indicates that the subject is resistant to treatment with an AKTl inhibitor or another agent of interest, such as an epidermal growth factor receptor antagonist, a platelet derived growth factor receptor (PDGFR) antagonist, her2/neu antagonist, a mammalian target of rapamycin (mTOR) inhibitor, Toll-like receptor inhibitor, a nuclear factor (NF)κβ inhibitor, or a PD kinase inhibitor. The detection of a PH domain, such as amino acids 8-108 of AKTl protein with a lysine at position 17 can indicate that the subject has cancer, has a predisposition to develop cancer, indicates a poor prognosis for the subject, and/or indicates that the subject cannot be treated with an AKTl inhibitor. In additional embodiments, detection of a PH domain of AKTl protein with a glutamic acid at position 17 of AKTl indicates that the subject is sensitive to treatment with an AKTl inhibitor, does not have the cancer, is not predisposed to develop the cancer, indicates a good prognosis for the subject, and/or indicates that the subject can be treated with an AKTl inhibitor.

The cancer can be any cancer of interest. For example the cancer can be a hematological cancer, such as a leukemia, including an acute leukemia (such as acute lymphocytic leukemia, acute myelocytic leukemia, acute myelogenous leukemia and myeloblastic, promyelocytic, myelomonocytic, monocytic and erythroleukemia), a chronic leukemia (such as chronic myelocytic (granulocytic) leukemia, chronic myelogenous leukemia, and chronic lymphocytic leukemia), polycythemia vera, lymphoma, Hodgkin's disease, non-Hodgkin's lymphoma (indolent and high grade forms), multiple myeloma, Waldenstrom's macroglobulinemia, heavy chain disease, myelodysplastic syndrome, or myelodysplasia. The cancer can also be a solid cancer, such as a sarcoma or a carcinoma, including a fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, synovioma, mesothelioma, Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, lymphoid malignancy, pancreatic cancer, breast cancer, lung cancers, ovarian cancer, prostate cancer, hepatocellular carcinoma, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary adenocarcinomas, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile duct carcinoma, choriocarcinoma, Wilms' tumor, cervical cancer, testicular tumor, bladder carcinoma, and CNS tumors (such as a glioma, astrocytoma, medulloblastoma, craniopharyogioma, ependymoma, pinealoma, hemangioblastoma, acoustic neuroma, oligodendroglioma, menangioma, melanoma, neuroblastoma and retinoblastoma). In some examples, the cancer is an adenocarcinoma. In additional examples, the cancer is a cancer of the reproductive tissues, such as but not limited to ovarian cancer or breast cancer. In further examples, the cancer is a colorectal cancer.

Isolated nucleic acid molecules that comprise specified lengths of the AKTl sequence and/or flanking regions can be utilized in the methods disclosed herein. Such molecules may comprise at least 10, 15, 20, 23, 25, 30, 35, 40, 45 or 50 consecutive nucleotides of these sequences or more, and may be obtained from any region of the disclosed sequences. By way of example, the human AKTl and gene sequences may be apportioned into about halves or quarters based on sequence length, and the isolated nucleic acid molecules (such as oligonucleotides) may be derived from the first or second halves of the molecules, or any of the four quarters. Similarly, the human AKTl genomic sequence can be divided into introns and exons, and AKTl nucleic acid sequences from these introns, exons, or sequences bridging the intron/exon boundary can be used in the methods disclosed herein. In particular embodiments, isolated nucleic acid molecules comprise or overlap at least one residue position designated as being associated with a polymorphism that is predictive of cancer. Such polymorphism sites include position 49 of a nucleic acid encoding AKTl, such as SEQ ID NO:2 and the site of mutation shown by an X in SEQ ID NO:32.

A. Nucleic Acid Based Methods for Detecting a Single Nucleotide Polymorphism in AKTl

In some embodiments, the method includes detecting the presence of a nucleic acid encoding AKTl (for example a cDNA sequence), such as SEQ ID NO:2, wherein X is a lysine. In specific examples, the method can include detecting a G to A transition at position 49 in a nucleic acid encoding SEQ ID NO: 1. An exemplary nucleic acid sequence encoding SEQ ID NO: 1 is set forth below:

ATGAGCGACGTGGCTATTGTGAAGGAGGGTTGGCTGCACAAACGAGGGXAGTACAT CAAGACCTGGCGGCCACGCTACTTCCTCCTCAAGAATGATGGCACCTTCATTGGCT ACAAGGAGCGGCCGCAGGATGTGGACCAACGTGAGGCTCCCCTCAACAACTTCTCT GTGGCGCAGTGCCAGCTGATGAAGACGGAGCGGCCCCGGCCCAACACCTTCATCAT CCGCTGCCTGCAGTGGACCACTGTCATCGAACGCACCTTCCATGTGGAGACTCCTG AGGAGCGGGAGGAGTGGACAACCGCCATCCAGACTGTGGCTGACGGCCTCAAGAAG CAGGAGGAGGAGGAGATGGACTTCCGGTCGGGCTCACCCAGTGACAACTCAGGGGC TGAAGAGATGGAGGTGTCCCTGGCCAAGCCCAAGCACCGCGTGACCATGAACGAGT TTGAGTACCTGAAGCTGCTGGGCAAGGGCACTTTCGGCAAGGTGATCCTGGTGAAG GAGAAGGCCACAGGCCGCTACTACGCCATGAAGATCCTCAAGAAGGAAGTCATCGT GGCCAAGGACGAGGTGGCCCACACACTCACCGAGAACCGCGTCCTGCAGAACTCCA GGCACCCCTTCCTCACAGCCCTGAAGTACTCTTTCCAGACCCACGACCGCCTCTGC TTTGTCATGGAGTACGCCAACGGGGGCGAGCTGTTCTTCCACCTGTCCCGGGAGCG TGTGTTCTCCGAGGACCGGGCCCGCTTCTATGGCGCTGAGATTGTGTCAGCCCTGG ACTACCTGCACTCGGAGAAGAACGTGGTGTACCGGGACCTCAAGCTGGAGAACCTC ATGCTGGACAAGGACGGGCACATTAAGATCACAGACTTCGGGCTGTGCAAGGAGGG GATCAAGGACGGTGCCACCATGAAGACCTTTTGCGGCACACCTGAGTACCTGGCCC CCGAGGTGCTGGAGGACAATGACTACGGCCGTGCAGTGGACTGGTGGGGGCTGGGC GTGGTCATGTACGAGATGATGTGCGGTCGCCTGCCCTTCTACAACCAGGACCATGA GAAGCTTTTTGAGCTCATCCTCATGGAGGAGATCCGCTTCCCGCGCACGCTTGGTC CCGAGGCCAAGTCCTTGCTTTCAGGGCTGCTCAAGAAGGACCCCAAGCAGAGGCTT GGCGGGGGCTCCGAGGACGCCAAGGAGATCATGCAGCATCGCTTCTTTGCCGGTAT CGTGTGGCAGCACGTGTACGAGAAGAAGCTCAGCCCACCCTTCAAGCCCCAGGTCA CGTCGGAGACTGACACCAGGTATTTTGATGAGGAGTTCACGGCCCAGATGATCACC ATCACACCACCTGACCAAGATGACAGCATGGAGTGTGTGGACAGCGAGCGCAGGCC CCACTTCCCCCAGTTCTCCTACTCGGCCAGCGGCACGGCCTGA(SEQ ID NO: 2, wherein X is G or A) . In the wild-type human nucleic acid sequence encoding wild-type AKTl, the X at position 49 is a G. In the mutant human nucleic acid sequence encoding mutant AKTl , the X at position 49 is an A. It should be noted that wherein position 49 is referred to as related to SEQ ID NO:2, the numeration is with regard to the full- length sequence. The PH domain of AKTl is encoded by nucleotides form about 22 to about

326 of SEQ ID NO:2. In one embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is an A, in a sample from a subject of interest, indicates that the subject is resistant to an AKTl inhibitor. In a further embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is an A in a sample from the subject of interest indicates that a cancer is present. In another embodiment, in a subject without a diagnosis of cancer, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is an A, in a sample from the subject, indicates that the subject is prone to developing cancer. In a yet another embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is an A in a sample from the subject indicates the prognosis of a cancer in a subject. In several examples, the cancer is breast cancer, ovarian cancer or prostate cancer.

In one embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is a G, in a sample from a subject of interest, indicates that the subject is susceptible to treatment with an AKTl inhibitor. In a further embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is a G in a sample from the subject of interest indicates that a cancer is not present. In another embodiment, in a subject without a diagnosis of cancer, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is a G, in a sample from the subject, indicates that the subject is not likely to develop cancer. In a yet another embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:2 or sub-sequence thereof that includes position 49 of SEQ ID NO:2, wherein X is a G in a sample from the subject indicates a good prognosis of a cancer in a subject. In some embodiments, the method includes detecting the presence of a nucleic acid encoding AKTl, wherein the nucleic acid sequence is the genomic sequence for AKTl such as set forth in GENBANK ACCESSION NO. NCJ)OOO 14 available September 16, 2007, which is incorporated herein by reference in its entirety. A portion of the genomic sequence including the site of mutation is set forth below as SEQ ID NO:32, wherein X is a G or an A.

GTCTGACGGGTAGAGTGTGCGTGGCTCTCACCACCCGCACGTCTGTAGG GXAGTACATCAAGACCTGGCGGCCACGCTACTTCCTCCTCAAGAATGAT GGC (SEQ ID NO:32, wherein X is G or A). SEQ ID NO:32 includes the site of mutation and 50 bases to either side of the mutation. In the wild-type human genomic nucleic acid sequence encoding wild-type AKTl, the X is a G. In the mutant human genomic nucleic acid sequence encoding mutant AKTl, the X at is an A.

In one embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is an A, in a sample from a subject of interest, indicates that the subject is resistant to an AKTl inhibitor. In a further embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is an A in a sample from the subject of interest indicates that a cancer is present. In another embodiment, in a subject without a diagnosis of cancer, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is an A, in a sample from the subject, indicates that the subject is prone to developing cancer. In a yet another embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is an A in a sample from the subject indicates the prognosis of a cancer in a subject. In several examples, the cancer is breast cancer, ovarian cancer or prostate cancer.

In one embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is a G, in a sample from a subject of interest, indicates that the subject is susceptible to treatment with an AKTl inhibitor. In a further embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is a G in a sample from the subject of interest indicates that a cancer is not present. In another embodiment, in a subject without a diagnosis of cancer, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is a G, in a sample from the subject, indicates that the subject is not likely to develop cancer. In a yet another embodiment, detection of a nucleic acid sequence set forth as SEQ ID NO:32 or sub-sequence thereof that includes position 51 of SEQ ID NO:32, wherein X is a G in a sample from the subject indicates a good prognosis of a cancer in a subject. The biological sample may be any, which is conveniently taken from the patient and contains sufficient information to yield reliable results. Typically, the biological sample will be a biological fluid or a tissue sample that contains, for example about 1 to about 10,000,000 cells. In one embodiment, the sample contains about 1000 to about 10,000,000 cells, or from about 1,000,000 to 10,000,000 somatic cells. It is possible to obtain samples which contain smaller numbers of cells (for example about 1 to about 1,000 cells) and then enrich the sample. In addition, with certain highly sensitive assays (such as reverse transcriptase polymerase chain reaction (RT-PCR)) it is possible to get sample size down to single cell level. The sample need not contain any intact cells, so long as it contains sufficient biological material (for example a nucleic acid, such as DNA or RNA) to assess the presence or absence of a mutation in nucleic acid molecules obtained from the subject. The biological or tissue sample can be drawn from the tissue which is susceptible to the type of disease to which the detection test is directed. For example, the tissue may be obtained by surgery, biopsy, swab, or other collection method from the tissue of interest. In addition, a blood sample or a sputum sample can be used. In several examples, the cancer is breast cancer, ovarian cancer or prostate cancer, and a biopsy sample of the cancer, or a blood sample from the subject, is utilized for the analysis. In one embodiment, the biological sample is a blood sample or a portion thereof, such as a serum sample. The blood sample may be obtained in any conventional way, such as finger prick or phlebotomy. Suitably, the blood sample is approximately 0.1 to 20 ml, or from about 1 to 15 ml, or about 10 ml of blood.

Southern hybridization is also an effective method of identifying differences in sequences. Hybridization conditions, such as salt concentration and temperature can be adjusted for the sequence to be screened. Southern blotting and hybridization protocols are described in Current Protocols in Molecular Biology (Greene

Publishing Associates and Wiley-Interscience, pages 2.9.1-2.9.10). Very high specific activity probe can be obtained using commercially available kits such as the Ready-To-Go™ DNA Labeling Beads (Pharmacia Biotech), following the manufacturer's protocol. Restriction fragment length polymorphism (RFLP) is an additional method of identifying differences in sequences. Restriction enzyme polymorphism allows differences to be established by comparing the characteristic polymorphic patterns that are obtained when certain regions of genomic DNA are cut with various restriction enzymes. In one embodiment, the genomic DNA is amplified prior to being cut with the restriction enzymes.

In some embodiments, the nucleic acid encoding the PH domain of AKTl, such as a nucleic acid encoding amino acids 8-108 of SEQ ID NO:1 or a subsequence thereof is amplified. In some embodiments, a portion of a nucleic acid sequence encoding the PH domain of AKTl that includes the site of mutation at position 17 of SEQ ID NO:1 is amplified. In some embodiments, a sequence including a portion of the AKTl nucleotide sequence according to SEQ ID NO:2 and including nucleotide 49 of SEQ ID NO:2 is amplified. In some embodiments, a sequence including a portion of the AKTl nucleotide sequence according to SEQ ID NO:32 and including nucleotide 51 of SEQ ID NO:32 is amplified. Amplification of a selected, or target, nucleic acid sequence encoding the PH domain of AKTl can be carried out by any suitable means (see for example Kwoh Kwoh, Am Biotechnol Lab, 8, 14, 1990). Examples of suitable amplification techniques include, but are not limited to, polymerase chain reaction, ligase chain reaction (see for example Barany, Proc Natl Acad Sci USA 88: 189, 1991), strand displacement amplification (see for example Walker et ah, Nucleic Acids Res. 20: 1691, 1992; Walker et ah, Proc Natl Acad Sci USA 89:392, 1992), transcription-based amplification (see for example Kwoh et al, Proc Natl Acad Sci USA , 86:1173, 1989), self-sustained sequence replication (or "3SR") (see for example Guatelli et al., Proc Natl Acad Sci USA , 87:1874 , 1990), the Q β-replicase system (see for example Lizardi et al., Biotechnology, 6:1197, 1988), nucleic acid sequence-based amplification (or "NASBA") (see for example Lewis, Genetic Engineering News, 12(9): 1, 1992), the repair chain reaction (or "RCR") (see for example Lewis, Genetic Engineering News, 12(9): 1, 1992), and boomerang DNA amplification (or "BDA") (see for example Lewis, Genetic Engineering News, 12(9):1, 1992). In one specific non- limiting example, polymerase chain reaction is utilized.

Single strand polymorphism assay ("SSPA") analysis and the closely related heteroduplex analysis methods can be used as effective methods for screening for single-base polymorphisms (Orita, et al, Proc Natl Acad Sci USA, 86:2766, 1989). In these methods, the mobility of PCR-amp lifted test DNA from clinical specimens is compared with the mobility of DNA amplified from normal sources by direct electrophoresis of samples in adjacent lanes of native polyacrylamide or other types of matrix gels. Single-base changes often alter the secondary structure of the molecule sufficiently to cause slight mobility differences between the normal and mutant PCR products after prolonged electrophoresis.

Ligase chain reaction is yet another recently developed method of screening for mutated nucleic acids. Ligase chain reaction (LCR) is also carried out in accordance with known techniques. LCR is especially useful to amplify, and thereby detect, single nucleotide differences between two DNA samples. In general, the reaction is called out with two pairs of oligonucleotide probes: one pair binds to one strand of the sequence to be detected; the other pair binds to the other strand of the sequence to be detected. The reaction is carried out by, first, denaturing the strands of the sequence to be detected, then reacting the strands with the two pairs of oligonucleotide probes in the presence of a heat stable ligase so that each pair of oligonucleotide probes hybridize to target DNA and, if there is perfect complementarity at their junction, adjacent probes are ligated together. The hybridized molecules are then separated under denaturation conditions. The process is cyclically repeated until the sequence has been amplified to the desired degree. Detection may then be carried out in a manner like that described above with respect to PCR.

For amplification of mRNAs, it is within the scope of the present disclosure to reverse transcribe mRNA into cDNA followed by polymerase chain reaction (RT- PCR); or, to use a single enzyme for both steps as described in U.S. Pat. No. 5,322,770 or, to use Asymmetric Gap LCR (RT-AGLCR) as described by Marshall et al. (1994). AGLCR is a modification of GLCR that allows the amplification of RNA.

A variety of PCR techniques are familiar to those skilled in the art. For a review of PCR technology, see White (1997) and the publication entitled "PCR Methods and Applications" (1991, Cold Spring Harbor Laboratory Press). In each of these PCR procedures, PCR primers on either side of the nucleic acid sequences to be amplified are added to a suitably prepared nucleic acid sample along with dNTPs and a thermostable polymerase such as Taq polymerase, Pfu polymerase, or Vent polymerase. The nucleic acid in the sample is denatured and the PCR primers are specifically hybridized to complementary nucleic acid sequences in the sample. The hybridized primers are extended. Thereafter, another cycle of denaturation, hybridization, and extension is initiated. The cycles are repeated multiple times to produce an amplified fragment containing the nucleic acid sequence between the primer sites (see also U.S. Patent No. 4,683,195, 4,683,202 and U.S. Patent No. 4,965,188). In a further embodiment, the primers can bind both a nucleic acid encoding the wild-type PH domain of AKTl and the mutated PH domain of AKTl . An amplification reaction is performed and the resulting nucleic acid is sequenced. Screening for mutated nucleic acids can be accomplished by direct sequencing of nucleic acids. A nucleic acid encoding the PH domain of AKTl, or encoding the AKTl polypeptide, can be sequenced to determine the exact nature of the mutation. Nucleic acid sequences can be determined through a number of different techniques which are well known to those skilled in the art. Nucleic acid sequencing can be performed by chemical or enzymatic methods. The enzymatic method relies on the ability of DNA polymerase to extend a primer, hybridized to the template to be sequenced, until a chain-terminating nucleotide is incorporated. The most common methods utilize didoexynucleotides. Primers may be labeled with radioactive or fluorescent labels. Various DNA polymerases are available including Klenow fragment, AMV reverse transcriptase, Thermus aquaticus DNA polymerase, and modified T7 polymerase.

Microsequencing reactions can also be performed on a nucleic acid including a PH domain of AKTl contained in amplified nucleic acids from samples taken from individuals of interest. In some embodiments, DNA samples are subjected to PCR amplification of the PH domain of AKTl . The genomic amplification products are then subjected to automated microsequencing reactions using ddNTPs (specific fluorescence for each ddNTP) and appropriate oligonucleotide microsequencing primers which can hybridize just upstream of the polymorphic base of interest. Once specifically extended at the 3' end by a DNA polymerase using a complementary fluorescent dideoxynucleotide analog (thermal cycling), the primer is precipitated to remove the unincorporated fluorescent ddNTPs. The reaction products in which fluorescent ddNTPs have been incorporated are then analyzed by electrophoresis on automated sequencing machines to determine the identity of the incorporated base, thereby identifying the polymorphic marker present in the sample.

An example of a typical sequencing procedure is provided in the Examples section. It is to be understood that certain parameters of this procedure such as the electrophoresis method or the labeling of ddNTPs could be modified by the skilled person without substantially modifying its result. An extended primer can also be analyzed by MALDI-TOF Mass Spectrometry. The base at the polymorphic site is identified by the mass added onto the microsequencing primer. As a further alternative to the process described above, several solid phase microsequencing reactions have been developed. The basic microsequencing protocol is the same as described previously, except that either the oligonucleotide microsequencing primers or the PCR-amp lifted products of the DNA fragment of interest are immobilized. For example, immobilization can be carried out by an interaction between biotinylated DNA and streptavidin-coated microtitration wells or avidin-coated polystyrene particles.

In such solid phase microsequencing reactions, incorporated ddNTPs can either be radiolabeled or linked to a fluorescent marker, such as fluorescein. The detection of radiolabeled ddNTPs can be achieved through scintillation-based techniques. The detection of fluorescein-linked ddNTPs can be based on the binding of antifluorescein antibody conjugated with alkaline phosphatase, followed by incubation with a chromogenic substrate (such as p-nitrophenyl phosphate). Other possible of reporter-detection couples include: ddNTP linked to dinitrophenyl (DNP) and anti-DNP alkaline phosphatase conjugate and biotinylated ddNTP and horseradish peroxidase-conjugated streptavidin with o- phenylenediamine as a substrate (see for example PCT Publication No. WO 92/15712). A diagnosis kit based on fluorescein-linked ddNTP with antifluorescein antibody conjugated with alkaline phosphatase is commercialized under the name PRONTO® by GamidaGen Ltd.

Solid-phase DNA sequencing can also be utilized that relies on the detection of DNA polymerase activity by an enzymatic luminometric inorganic pyrophosphate detection assay (ELIDA). The PCR-amplified products are biotinylated and immobilized on beads. The microsequencing primer is annealed and four aliquots of this mixture are separately incubated with DNA polymerase and one of the four different ddNTPs. After the reaction, the resulting fragments are washed and used as substrates in a primer extension reaction with all four dNTPs present. The progress of the DNA-directed polymerization reactions are monitored with the ELIDA. Incorporation of a ddNTP in the first reaction prevents the formation of pyrophosphate during the subsequent dNTP reaction. In contrast, no ddNTP incorporation in the first reaction gives extensive pyrophosphate release during the dNTP reaction and this leads to generation of light throughout the ELIDA reactions. From the ELIDA results, the first base after the primer is easily deduced. Methods for multiplex detection of single nucleotide polymorphism are also known in the art which the solid phase minisequencing principle is applied to an oligonucleotide array format. An amplified AKTl nucleic acid can be detected in real-time, for example by real-time PCR, in order to determine the presence, and/or the amount of a mutant AKTl or wild-type (WT) AKTl nucleic acid. In this manner, an amplified nucleic acid sequence, such as an amplified mutant AKTl or WILD-TYPE AKTl nucleic acid nucleic acid sequence, can be detected using a probe specific for the product amplified from the AKTl nucleic acid sequence of interest, such as an amplified an mutant AKTl or WILD-TYPE AKTl nucleic acid sequence.

Real-time PCR monitors the fluorescence emitted during the reaction as an indicator of amplicon production during each PCR cycle as opposed to the endpoint detection. The real-time progress of the reaction can be viewed in some systems. Typically, real-time PCR uses the detection of a fluorescent reporter. Typically, the fluorescent reporter's signal increases in direct proportion to the amount of PCR product in a reaction. By recording the amount of fluorescence emission at each cycle, it is possible to monitor the PCR reaction during exponential phase where the first significant increase in the amount of PCR product correlates to the initial amount of target template. The higher the starting copy number of the nucleic acid target, the sooner a significant increase in fluorescence is observed.

In one embodiment, the fluorescently-labeled probes rely upon fluorescence resonance energy transfer (FRET), or in a change in the fluorescence emission wavelength of a sample, as a method to detect hybridization of a DNA probe to the amplified target nucleic acid in real-time. For example, FRET that occurs between fluorogenic labels on different probes (for example, using HybProbes) or between a fluorophore and a non-fluorescent quencher on the same probe (for example, using a molecular beacon or a TAQMAN® probe) can identify a probe that specifically hybridizes to the DNA sequence of interest and in this way, using a probe for mutant AKTl, can detect the presence mutant AKTl in a sample. In some embodiments, the fluorescently-labeled DNA probes used to identify amplification products have spectrally distinct emission wavelengths, thus allowing them to be distinguished within the same reaction tube, for example in multiplex PCR, for example a multiplex real-time PCR. In some embodiments, the probes and primers disclosed herein are used in multiplex real-time PCR.

In another embodiment, a melting curve analysis of the amplified target nucleic acid can be performed subsequent to the amplification process. The T_m of a nucleic acid sequence depends on the length of the sequence and its G/C content. Thus, the identification of the T_m for a nucleic acid sequence can be used to identify the amplified nucleic acid, for example by using double-stranded DNA binding dye chemistry, which quantitates the amplicon production by the use of a non-sequence specific fluorescent intercalating agent (such as SYBR-green or ethidium bromide). SYBR green is a fluorogenic minor groove binding dye that exhibits little fluorescence when in solution but emits a strong fluorescent signal upon binding to double-stranded DNA. Typically, SYBR green is used in singleplex reactions, however when coupled with melting point analysis, it can be used for multiplex reactions.

Any type of thermal cycler apparatus can be used for the amplification of the AKTl nucleic acid, such as a mutant or WILD-TYPE AKTl nucleic acid and/or the determination of hybridization. Examples of suitable apparatuses include a PTC- 100® Peltier Thermal Cycler (MJ Research, Inc.; San Francisco, CA), a ROBOCYCLER® 40 Temperature Cycler (Stratagene; La Jolla, CA), or a

GENEAMP® PCR System 9700 (Applied Biosystems; Foster City, CA). For realtime PCR, any type of real-time thermocycler apparatus can be used. For example, a BioRad iCycler iQTM, LIGHTCYCLER™ (Roche; Mannheim, Germany), a 7700 Sequence Detector (Perkin Elmer/ Applied Biosystems; Foster City, CA), ABI™ systems such as the 7000, 7500, 7700, or 7900 systems (Applied Biosystems; Foster City, CA), or an MX4000™, MX3000™ or MX3005™ (Stratagene; La Jolla, CA); DNA Engine Opticon Continuous Fluorescence Detection System (MJ Research); and Cepheid SMARTCYCLER™ can by used to amplify nucleic acid sequences in real-time. In some embodiments, probes that specifically bind to a mutant or wild-type sequence of AKTl nucleic acid sequence are used to detect a mutation in the AKTl nucleic acid sequence. In some examples, a probe is used to detect a wild-type AKTl nucleic acid, wherein the probe binds to a wild-type AKTl nucleic acid sequence set forth as SEQ ID NO:2 that includes nucleotide 49 of SEQ ID NO:2 in which X is an G. In some examples, a probe is used to detect a wild-type AKTl nucleic acid, wherein the probe binds to the antisense strand of wild-type AKTl nucleic acid sequence set forth as SEQ ID NO:2 that includes nucleotide 49 of SEQ ID NO:2, in which X is an G. In some examples, a probe is used to detect a mutant AKTl nucleic acid, wherein the probe binds to a mutant AKTl nucleic acid sequence set forth as SEQ ID NO:2 that includes nucleotide 49 of SEQ ID NO:2, in which X is an A. In some examples, a probe is used to detect a mutant AKTl nucleic acid, wherein the probe binds to a the antisense strand of a mutant AKTl nucleic acid sequence set forth as SEQ ID NO:2 that includes nucleotide 49 of SEQ ID NO:2, in which X is an A.

Exemplary 20 nucleic acid probes for identifying a mutation SEQ ID NO:2 are given in Table 1 bellow.

Table 1: 20 Nucleotide Long Probes for Detecting AKTl Mutations in SEQ ID NO:2

^Nucleotides refer to SEQ ID NO:2 .

In some examples, a probe is used to detect a wild-type AKTl nucleic acid, wherein the probe binds to a wild-type AKTl nucleic acid sequence set forth as SEQ ID NO:32 that includes nucleotide 51 of SEQ ID NO:32 in which X is an G. In some examples, a probe is used to detect a wild-type AKTl nucleic acid, wherein the probe binds to the antisense strand of wild-type AKTl nucleic acid sequence set forth as SEQ ID NO:32 that includes nucleotide 51 of SEQ ID NO:32, in which X is an G. In some examples, a probe is used to detect a mutant AKTl nucleic acid, wherein the probe binds to a mutant AKTl nucleic acid sequence set forth as SEQ ID NO:32 that includes nucleotide 51 of SEQ ID NO:32, in which X is an A. In some examples, a probe is used to detect a mutant AKTl nucleic acid, wherein the probe binds to a the antisense strand of a mutant AKTl nucleic acid sequence set forth as SEQ ID NO:32 that includes nucleotide 51 of SEQ ID NO:32, in which X is an A. Exemplary 20 nucleotide probes for identifying a mutation SEQ ID NO:32 are given in Table 2 below.

Table 2: 20 Nucleotide Long Probes for Detecting AKTl Mutations in SEQ ID NO:2

^Nucleotides refer to SEQ ID NO:32 (either strand)

Nucleic acid probes and primers of any length can be made according to the pattern above using the SEQ ID NO:2 and SEQ ID NO:32 provided herein, such as probes 12, 13, 14, 15, 16, 17, 17, 19, 20, 21, 22, 23, 24, 25 or even greater than 25 nucleotides in length.

B. Protein Based Methods for Detecting a Single Base Polymorphism in the PH Domain of AKTl

In several embodiments, the methods disclosed herein include obtaining a biological sample from a subject; and screening the biological sample for the presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO: 1, wherein amino acid 17 is a lysine. The presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a lysine indicates a subject with cancer cannot successfully be treated with (or clinically respond to) an AKTl inhibitor, or is resistant to treatment with an epidermal growth factor receptor antagonist, a platelet derived growth factor receptor (PDF) antagonist, her2/neu antagonist, a mammalian target of rapamycin (mTOR) inhibitor, Toll-like receptor inhibitor, a nuclear factor (NF)κβ inhibitor, or a PI3 kinase inhibitor. The presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a lysine can also indicate that the subject has cancer, indicates a poor prognosis for the subject, or indicates that the subject has a predisposition to developing the cancer.

In additional embodiments, the methods disclosed herein include obtaining a biological sample from a subject; and screening the biological sample for the presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO : 1 , wherein amino acid 17 is a glutamic acid. The presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a glutamic acid indicates a subject with cancer is likely to be successfully treated with (or clinically respond to) an AKTl inhibitor. The presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO: 1 can indicate that the subject can be treated with an epidermal growth factor receptor antagonist, a platelet derived growth factor receptor (PDGFR) antagonist, her2/neu antagonist, a mammalian target of rapamycin (mTOR) inhibitor, Toll-like receptor inhibitor, a nuclear factor (NF)κβ inhibitor, or a PD kinase inhibitor. The presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a glutamic can also indicate that the subject does not have cancer, indicates a good prognosis for the subject, or indicates that the subject does not have a predisposition to getting the cancer.

Polymorphic AKTl polypeptides may be detected through novel epitopes recognized by polyclonal and/or monoclonal antibodies used in ELISA, immunoblotting, flow cytometric, immunohistochemical and other polypeptide polymorphism detection strategies (Wong et al, Cancer Res., 46: 6029-6033, 1986; Luwor et al, Cancer Res., 61 : 5355-5361, 2001; Mishima et al., Cancer Res., 61 : 5349-5354, 2001; Ijaz et al, J. Med. Virol, 63: 210-216, 2001). Generally these methods utilize antibodies, such as monoclonal or polyclonal antibodies. An antibody that specifically binds a wild-type AKTl polypeptide (such as a polypeptide with the amino acid sequence set forth as SEQ ID NO:1, wherein amino acid 17 is a glutamic acid) does not bind detectable amounts of a mutant AKTl polypeptide (such as a polypeptide with the amino acid sequence set forth as SEID NO:1, wherein amino acid 17 is a lysine). In one example, an antibody that specifically binds a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 of SEQ ID NO: 1 is a glutamic acid does not bind detectable amounts of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1 wherein amino acid 17 is a lysine. In another example, an antibody that specifically binds an AKTl polypeptide wherein amino acid 17 is a lysine does not bind detectable amounts of an AKTl polypeptide wherein amino acid 17 is a glutamic acid. In a further example, an antibody that specifically binds a polypeptide including amino acids 8 to 108 of SEQ ID NO : 1 , wherein amino acid 17 of SEQ ID NO : 1 is a lysine does not bind detectable amounts of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1 wherein amino acid 17 is a glutamic acid. Generally, an antibody specifically binds to AKTl (with either lysine or glutamic acid at position 17) with an affinity constant of at least 10⁷ M^"1, such as at least 10⁸ M^"1 at least 5 X 10⁸ M^"1 or at least 10⁹ M^"1. All of these antibodies are of use in the methods disclosed herein.

The preparation of polyclonal antibodies is well known to those skilled in the art. See, for example, Green et al., "Production of Polyclonal Antisera," in: Immunochemical Protocols pages 1-5, Manson, ed., Humana Press 1992; Coligan et al., "Production of Polyclonal Antisera in Rabbits, Rats, Mice and Hamsters," in: Current Protocols in Immunology, section 2.4.1, 1992.

The preparation of monoclonal antibodies likewise is conventional. See, for example, Kohler & Milstein, Nature 256:495, 1975; Coligan et al., sections 2.5.1- 2.6.7; and Harlow et al., in: Antibodies: a Laboratory Manual, page 726, Cold Spring Harbor Pub., 1988. Briefly, monoclonal antibodies can be obtained by injecting mice with a composition including an antigen or a cell of interest, verifying the presence of antibody production by removing a serum sample, removing the spleen to obtain B lymphocytes, fusing the B lymphocytes with myeloma cells to produce hybridomas, cloning the hybridomas, selecting positive clones that produce antibodies to the antigen, and isolating the antibodies from the hybridoma cultures. Monoclonal antibodies can be isolated and purified from hybridoma cultures by a variety of well-established techniques. Such isolation techniques include affinity chromatography with Protein-A Sepharose, size-exclusion chromatography, and ion- exchange chromatography. See, e.g., Coligan et al., sections 2.7.1-2.7.12 and sections 2.9.1-2.9.3; Barnes et al., "Purification of Immunoglobulin G (IgG)," in: Methods in Molecular Biology, Vol. 10, pages 79-104, Humana Press, 1992.

Methods of in vitro and in vivo multiplication of monoclonal antibodies are well known to those skilled in the art. Multiplication in vitro may be carried out in suitable culture media such as Dulbecco's Modified Eagle Medium or RPMI 1640 medium, optionally supplemented by a mammalian serum such as fetal calf serum or trace elements and growth-sustaining supplements such as normal mouse peritoneal exudate cells, spleen cells, thymocytes or bone marrow macrophages. Production in vitro provides relatively pure antibody preparations and allows scale-up to yield large amounts of the desired antibodies. Large-scale hybridoma cultivation can be carried out by homogenous suspension culture in an airlift reactor, in a continuous stirrer reactor, or in immobilized or entrapped cell culture. Multiplication in vivo may be carried out by injecting cell clones into mammals histocompatible with the parent cells, e.g., syngeneic mice, to cause growth of antibody-producing tumors. Optionally, the animals are primed with a hydrocarbon, especially oils such as pristane (tetramethylpentadecane) prior to injection. After one to three weeks, the desired monoclonal antibody is recovered from the body fluid of the animal. Humanized monoclonal antibodies are produced by transferring mouse complementarity determining regions from heavy and light variable chains of the mouse immunoglobulin into a human variable domain, and then substituting human residues in the framework regions of the murine counterparts. The use of antibody components derived from humanized monoclonal antibodies obviates potential problems associated with the immunogenicity of murine constant regions. General techniques for cloning murine immunoglobulin variable domains are described, for example, by Orlandi et al., Proc. Nat'l Acad. ScL U.S.A. 86:3833, 1989. Techniques for producing humanized monoclonal antibodies are described, for example, by Jones et al., Nature 321 :522, 1986; Riechmann et al., Nature 332:323, 1988; Verhoeyen et al., Science 239:1534, 1988; Carter et al., Proc. Nat'l Acad. ScL U.S.A. 89:4285, 1992; Sandhu, Crit. Rev. Biotech. 12:437, 1992; and Singer et al., J. Immunol. 150:2844, 1993.

Antibodies include intact molecules as well as functional fragments thereof, such as Fab, F(ab')2, and Fv which are capable of binding the epitopic determinant. These antibody fragments retain some ability to selectively bind with their antigen. Methods of making these fragments are known in the art. (See for example, Harlow and Lane, Antibodies: A Laboratory Manual, Cold Spring Harbor Laboratory, New York, 1988). Binding affinity for a target antigen is typically measured or determined by standard antibody-antigen assays, such as competitive assays, saturation assays, or immunoassays such as ELISA or RIA. Such assays can be used to determine the dissociation constant of the antibody. The phrase "dissociation constant" refers to the affinity of an antibody for an antigen. Specificity of binding between an antibody and an antigen exists if the dissociation constant (K_D = 1/K, where K is the affinity constant) of the antibody is, for example < 1 μM, < 100 nM, or < 0.1 nM. Antibody molecules will typically have a K_D in the lower ranges. K_D = [Ab- Ag]/[Ab][Ag] where [Ab] is the concentration at equilibrium of the antibody, [Ag] is the concentration at equilibrium of the antigen and [Ab-Ag] is the concentration at equilibrium of the antibody-antigen complex. Typically, the binding interactions between antigen and antibody include reversible noncovalent associations such as electrostatic attraction, Van der Waals forces and hydrogen bonds.

The antibodies used in the methods disclosed herein can be labeled. The enzymes that can be conjugated to the antibodies include, but are not limited to, alkaline phosphatase, peroxidase, urease and β-galactosidase. The fluorochromes that can be conjugated to the antibodies include, but are not limited to, fluorescein isothiocyanate, tetramethylrhodamine isothiocyanate, phycoerythrin, allophycocyanins and Texas Red. For additional fluorochromes that can be conjugated to antibodies see Haugland, R. P., Molecular Probes: Handbook of

Fluorescent Probes and Research Chemicals (1992-1994). The metal compounds that can be conjugated to the antibodies include, but are not limited to, ferritin, colloidal gold, and particularly colloidal superparamagnetic beads. The haptens that can be conjugated to the antibodies include, but are not limited to, biotin, digoxigenin, oxazalone, and nitrophenol. The radioactive compounds that can be conjugated or incorporated into the antibodies are known to the art, and include but are not limited to technetium 99m (" Tc), ¹²⁵ 1 and amino acids including any radionucleotides, including but not limited to, ¹⁴ C, ³ H and ³⁵ S.

AKTl polypeptides also can be detected by mass spectrometry assays for example coupled to immunaffinity assays, the use of matrix-assisted laser desorption/ionization time-of- flight (MALDI-TOF) mass mapping and liquid chromatography/quadrupole time-of- flight electrospray ionization tandem mass spectrometry (LC/Q-TOF-ESI-MS/MS) sequence tag of tumor derived proteins separated by two-dimensional polyacrylamide gel electrophoresis (2D-P AGE) (Kiernan et al., Anal. Biochem., 301 : 49-56, 2002; Poutanen et al., Mass Spectrom., 15: 1685-1692, 2001). All of these approaches may be used to detect a sequence anomaly or variant of an AKTl polypeptide, such as a polymorphism at amino acid 17.

The presence of a polypeptide including amino acid 8 to 108 of SEQ ID NO: 1 can be determined with multiple specific binding agents, such as one, two, three, or more specific binding agents. Thus, the methods can utilize more than one antibody. In some embodiments, one of the antibodies is attached to a solid support, such as a multiwell plate (such as, a microtiter plate), bead, membrane or the like. In practice, microtiter plates may conveniently be utilized as the solid phase. The surfaces may be prepared in advance, stored, and shipped to another location(s). However, antibody reactions also can be conducted in a liquid phase. In some examples, a first and second specific binding agent are used that are tagged with different detectable labels. In one example, the first and second tag interact when in proximity, such as when the specific binding agents are bound to the same target, for example an antibody that specifically binds a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a glutamic acid and an antibody that specifically binds the C-terminus of SEQ ID NO: 1 (for example, due to resonance transfer). The relative proximity of the first and second tags is determined by measuring a change in the intrinsic fluorescence of the first or second tag. Commonly, the emission of the first tag is quenched by proximity of the second tag. After incubation, the presence or absence of a detectable tag emission is detected. The detected emission can be any of the following: an emission by the first tag, an emission by the second tag, and an emission resulting from a combination of the first and second tag. Typically, to detect the presence of a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a glumatic acid, a change in the signal, due to binding of the two specific binding agents, is detected (for example, as an increase in fluorescence as a result of FRET, as an increase in quenching that leads to an decrease in signal from either or both of the tags, a change in signal color, and the like). Many appropriate interactive tags are known. For example, fluorescent tags, dyes, enzymatic tags, and antibody tags are all appropriate. Examples of preferred interactive fluorescent tag pairs include terbium chelate and TRITC (tetramethylrhodamine isothiocyanate), europium cryptate and allophycocyanin and many others known to one of ordinary skill in the art. Similarly, two colorimetric tags can result in combinations that yield a third color, for example, a blue emission in proximity to a yellow emission provides an observed green emission. With regard to preferred fluorescent pairs, there are a number of fluorophores that are known to quench one another. Fluorescence quenching is a bimolecular process that reduces the fluorescence quantum yield, typically without changing the fluorescence emission spectrum. Quenching can result from transient excited state interactions, (collisional quenching) or, for example, from the formation of nonfluorescent ground state species. Self quenching is the quenching of one fluorophore by another; it tends to occur when high concentrations, labeling densities, or proximity of tags occurs. Fluorescent resonance energy transfer

(FRET) is a distance dependent excited state interaction in which emission of one fluorophore is coupled to the excitation of another that is in proximity (close enough for an observable change in emissions to occur). Some excited fluorophores interact to form excimers, which are excited state dimers that exhibit altered emission spectra (for example, phospholipid analogs with pyrene sn-2 acyl chains); see, Haugland (1996) Handbook of Fluorescent Probes and Research Chemicals, Published by Molecular Probes, Inc., Eugene, Oregon, for example at chapter 13).

In most uses, the first and second tags are different, in which case FRET can be detected by the appearance of sensitized fluorescence of the acceptor or by quenching of the donor fluorescence. When the first and second tags are the same, FRET is detected by the resulting fluorescence depolarization. In addition to quenching between fluorophores, individual fluorophores are also quenched by nitroxide-tagged molecules such as fatty acids. Spin tags such as nitroxides are also useful in the liquid phase assays describer herein. Liquid phase assays described herein can be performed in essentially any liquid phase container for example a container designed for high throughput screening such as a multiwell microtiter dish (for example, 96 well, 384 well, etc). Kits and High Throughput Systems

In one embodiment there are provided methods, compositions and kits for genotyping AKTl in an individual. The genotyping method comprises identifying the nucleotides encoding AKTl in one or both copies of the AKTl gene(s) from the individual.

Specific contemplated genotyping compositions comprise an oligonucleotide probe or primer that overlaps (e.g. includes) and is designed to specifically hybridize to a target region containing, or adjacent to, a codon encoding amino acid 17 of SEQ ID NO: 1. For example, an oligonucleotide probe and/or primer that is designed to identify the nucleotide 49 of SEQ ID NO:2 can be included in the kit. In another example, an oligonucleotide probe and/or primer that is designed to identify the nucleotide at position 51 of SEQ ID NO:32 can be included in the kit. A representative genotyping kit comprises one or more oligonucleotide(s) designed to genotype one AKTl . The provided genotyping methods, compositions, and kits are useful, for instance, for identifying an individual, or collection of individuals, that has one of the genotypes described herein, and to determine if AKTl inhibitors can be used to treat cancer(s) in that individual. Exemplary probes and primers detecting AKTl are disclosed herein; the kit can include any number of the specific primers disclosed in the examples section. A kit can optionally include instructional material, such as directions for use in written, video or digital format.

This disclosure also provides integrated systems for high-throughput screening of agents for an effect on AKTl mutant proteins, such as AKTl proteins with an amino acid substitution at amino acid residue 17 of SEQ ID NO: 1. The systems typically include a robotic armature that transfers fluid from a source to a destination, a controller that controls the robotic armature, a tag detector, a data storage unit that records tag detection, and an assay component such as a microtiter dish comprising a well having a reaction mixture.

A number of robotic fluid transfer systems are available, or can easily be made from existing components. For example, a ZYMATE™ XP (Zymark

Corporation; Hopkinton, Mass.) automated robot using a Microlab 2200 (Hamilton; Reno, Nev.) pipetting station can be used to transfer parallel samples to 96 well microtiter plates to set up several parallel simultaneous assays of samples.

Optional, optical images can viewed (and, if desired, recorded for future analysis) by a camera or other recording device (for example, a photodiode and data storage device) are optionally further processed in any of the embodiments herein, such as by digitalizing, storing, and analyzing the image on a computer. A variety of commercially available peripheral equipment and software is available for digitizing, storing and analyzing a digitized video or digitized optical image, e.g., using PC (Intelx86 or Pentium chip-compatible DOS™, OS2 ™ WINDOWS ™, WINDOWS NT ™ or WINDOWS95™ based computers), MACINTOSH™, or UNIX based (for example, a SUN™, a SGI™, or other work station) computers.

Screening Test agents

The methods disclosed herein are of use for identifying agents that can be used for treating cancer. An "agent" is any substance or any combination of substances that is useful for achieving an end or result. The agents identified using the methods disclosed herein can be of use for affecting the localization of AKTl, and can be of use for treating cancer. As disclosed herein, AKTl E17K localizes to the plasma membrane under serum-starved conditions. In contrast, wild-type AKTl is found in the cytoplasm and nucleus, but rapidly translocated to the plasma membrane on platelet-derived growth factor (PDGF) stimulation In addition, as disclosed herein, under serum- starved conditions, the level of membrane-associated AKT phosphorylated at Thr 308 and Ser 473 is also increased. Thus, methods for identifying an agent useful in treating cancer including identifying agents that affects the association of AKTl E17K with the plasma membrane and/or the phosphorylation of AKTl E17K at one or more of Ser 473 or Thr 308.

In some embodiments, a method for determining if an agent of interest is of use for treating cancer includes contacting an isolated cell expressing an AKTl polypeptide that includes a mutation corresponding to position 17 of SEQ ID NO: 2, wherein the amino acid at position 17 is a lysine with an agent of interest, detecting the AKTl polypeptide, and determining if the agent of interest inhibits the localization of the AKTl polypeptide to the plasma membrane. Inhibition of the localization of the AKTl polypeptide to the plasma membrane identifies the agent as of use for treating cancer. In some examples, the inhibition of the AKTl polypeptide to the plasma membrane is relative to a control, such as the basal level of AKTl mutant polypeptide with a lysine at position 17 localized to the plasma membrane. Alternatively, a control can be an isolated cell not treated with the agent. In some embodiments, the isolated cell is contacted with the agent under conditions of serum starvation. In some embodiments, the isolated cell is contacted with platelet derived growth factor. In some embodiments, the method further includes lysing the isolated cell, isolating the plasma membrane fraction of the lysed cell, and detecting the presence of the AKTl polypeptide in the plasma membrane fraction of the lysed cell, wherein a reduction in the amount of the AKTl polypeptide in the plasma membrane fraction relative to a control identifies the agent as of use for treating cancer. In some embodiments, the AKTl polypeptide is detected with an antibody that specifically binds AKTl . Detecting the effects of agent on a the phosphorylation of AKTl polypeptide at Ser 473 or Thr 308 can also be used to determine if an agent is of use for treating cancer. Such methods include contacting an isolated cell expressing an AKTl polypeptide that in includes a mutation corresponding to position 17 of SEQ ID NO: 2, wherein the amino acid at position 17 is a lysine, with an agent of interest and determining if the agent of interest inhibits the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308. Such as agent is identified as an agent of use in treating cancer. In some examples, the inhibition of the AKTl polypeptide to the plasma membrane is relative to a control, such as the value of the basal level of phosphorylation of AKTl mutant polypeptide at Ser 473 or Thr 308 with a lysine at position 17. Alternatively, a control can be an isolated cell not treated with the agent. In some embodiments, the isolated cell is contacted with the agent under conditions of serum starvation. In some embodiments, the isolated cell is contacted with platelet derived growth factor. In some embodiments, AKTl polypeptide is detected with an antibody that specifically binds an AKTl polypeptide phosphorylated at one or more of Ser 473 or Thr 308.

Any agent that has potential (whether or not ultimately realized) to inhibit localization of AKTl E17K to the plasma membrane and/or inhibit the phosphorylation of AKTl E17K at Thr 308 and Ser 473 is a candidate therapeutic agent for use in treating cancer. In several examples, the cancer is breast cancer, ovarian cancer or prostate cancer.

Exemplary agents include agents known to inhibit protein kinases, such as triazole compounds, pyrazolyamine substituted quinalzoine compounds, pyrazole compounds, indazole compounds, isoxaole compounds (see for example, U.S. Patent No. 7,115,739; U.S. Patent No. 7,098,330; U.S. Patent No. 7,087,603; U.S. Patent No. 7,041,687; U.S. Patent No. 7,008,948; U.S. Patent No. 6,989,385; U.S. Patent No. 6,743,791; U.S. Patent No. 6,696,452; U.S. Patent No. 6,664,247; U.S. Patent No. 6,660,731; U.S. Patent No. 6,653,301; U.S. Patent No. 6,653,300; U.S. Patent No. 6,649,640; U.S. Patent No. 6,638,926; U.S. Patent No. 6,613,776; U.S. Patent No. 6,660,677; and U.S. Patent No. 6,495,582, which are incorporated herein by reference. Exemplary agents also include agents that are epidermal growth factor receptor antagonists, platelet derived growth factor receptor (PDF) antagonists, her2/neu antagonists, mammalian target of rapamycin (mTOR) inhibitors, Toll-like receptor inhibitors, a nuclear factor (NF)κβ inhibitors, or a PI3 kinase inhibitors.

Exemplary agents include, but are not limited to, peptides such as, for example, soluble peptides, including but not limited to members of random peptide libraries (see, e.g., Lam et al, Nature, 354:82-84, 1991; Houghten et al, Nature, 354:84-86, 1991), and combinatorial chemistry-derived molecular library made of D-and/or L-configuration amino acids, phosphopeptides (including, but not limited to, members of random or partially degenerate, directed phosphopeptide libraries; see, e.g., Songyang et al, Cell, 72:767-778, 1993), antibodies (including, but not limited to, polyclonal, monoclonal, humanized, anti-idiotypic, chimeric or single chain antibodies, and Fab, F(ab')₂ and Fab expression library fragments, and epitope-binding fragments thereof), small organic or inorganic molecules (such as, so-called natural products or members of chemical combinatorial libraries), molecular complexes (such as protein complexes), or nucleic acids.

Appropriate agents can be contained in libraries, for example, synthetic or natural compounds in a combinatorial library. Numerous libraries are commercially available or can be readily produced; means for random and directed synthesis of a wide variety of organic compounds and biomolecules, including expression of randomized oligonucleotides, such as antisense oligonucleotides and oligopeptides, also are known. Alternatively, libraries of natural compounds in the form of bacterial, fungal, plant and animal extracts are available or can be readily produced. Additionally, natural or synthetically produced libraries and compounds are readily modified through conventional chemical, physical and biochemical means, and may be used to produce combinatorial libraries. Such libraries are useful for the screening of a large number of different compounds.

Libraries (such as combinatorial chemical libraries) useful in the disclosed methods include, but are not limited to, peptide libraries (see, e.g., U.S. Pat. No. 5,010,175; Furka, Int. J. Pept. Prot. Res., 37:487-493, 1991; Houghton et al,

Nature, 354:84-88, 1991; PCT Publication No. WO 91/19735), encoded peptides (e.g., PCT Publication WO 93/20242), random bio-oligomers (e.g., PCT Publication No. WO 92/00091), benzodiazepines (e.g., U.S. Pat. No. 5,288,514), diversomers such as hydantoins, benzodiazepines and dipeptides (Hobbs et al, Proc. Natl. Acad. Sci. USA, 90:6909-6913, 1993), vinylogous polypeptides (Hagihara et al, J. Am.

Chem. Soc, 114:6568, 1992), nonpeptidal peptidomimetics with glucose scaffolding (Hirschmann et al, J. Am. Chem. Soc, 114:9217-9218, 1992), analogous organic syntheses of small compound libraries (Chen et al, J. Am. Chem. Soc, 116:2661, 1994), oligocarbamates (Cho et al, Science, 261 : 1303, 1003), and/or peptidyl phosphonates (Campbell et al, J. Org. Chem., 59:658, 1994), nucleic acid libraries (see Sambrook et al Molecular Cloning, A Laboratory Manual, Cold Springs Harbor Press, N. Y., 1989; Ausubel et al, Current Protocols in Molecular Biology, Green Publishing Associates and Wiley Interscience, N. Y., 1989), peptide nucleic acid libraries (see, e.g., U.S. Pat. No. 5,539,083), antibody libraries (see, e.g., Vaughn et al, Nat. Biotechnol, 14:309-314, 1996; PCT App.

No. PCT/US96/10287), carbohydrate libraries (see, e.g., Liang et al, Science, 274:1520-1522, 1996; U.S. Pat. No. 5,593,853), small organic molecule libraries (see, for example, benzodiazepines, Baum, C&EN, Jan 18, page 33, 1993; isoprenoids, U.S. Pat. No. 5,569,588; thiazolidionones and methathiazones, U.S. Pat. No. 5,549,974; pyrrolidines, U.S. Pat. Nos. 5,525,735 and 5,519,134; morpholino compounds, U.S. Pat. No. 5,506,337; benzodiazepines, U.S. Patent No. 5,288,514) and the like. Libraries useful for the disclosed screening methods can be produced in a variety of manners including, but not limited to, spatially arrayed multipin peptide synthesis (Geysen, et al, Proc. Natl. Acad. ScL, 81(13):3998-4002, 1984), "tea bag" peptide synthesis (Houghten, Proc. Natl. Acad. ScL, 82(15):5131-5135, 1985), phage display (Scott and Smith, Science, 249:386-390, 1990), spot or disc synthesis (Dittrich et al., Bioorg. Med. Chem. Lett., 8(17):2351-2356, 1998), or split and mix solid phase synthesis on beads (Furka et al., Int. J. Pept. Protein Res., 37(6):487-493, 1991; Lam et al, Chem. Rev., 97(2):411-448, 1997). Libraries may include a varying number of compositions (members), such as up to about 100 members, such as up to about 1000 members, such as up to about 5000 members, such as up to about 10,000 members, such as up to about 100,000 members, such as up to about 500,000 members, or even more than 500,000 members.

In one convenient embodiment, high throughput screening methods involve providing a combinatorial chemical or peptide library containing a large number of potential therapeutic compounds. Such combinatorial libraries are then screened in one or more assays as described herein to identify those library members (particularly chemical species or subclasses) that display a desired characteristic activity. In one example an agent of use is identified that specifically binds a polypeptide including amino acids 8 to 108 of SEQ ID NO:1, wherein amino acid 17 is a lysine.

The compounds identified using the methods disclosed herein can serve as conventional "lead compounds" or can themselves be used as potential or actual therapeutics. In some instances, pools of candidate agents may be identified and further screened to determine which individual or subpools of agents in the collective have a desired activity.

In several embodiments, agents identified by the methods disclosed herein are useful in sensitizing tumors, for example tumors resistant to typical chemotherapeutic agents (such as DNA crosslinking agents, for example DNA alkylating agents). Thus, the agents identified using the methods disclosed herein can be used for the treatment of cancer in combination with additional chemotherapeutic agents. The disclosure is illustrated by the following non-limiting Examples.

EXAMPLES Example 1 This example describes a methods used to detect AKTl mutations in the coding sequence of the AKTl gene.

Aktl nucleic acid and polypeptide:

The genomic sequence encompassing the v-akt murine thymoma viral oncogene homo log 1 (AKTl) gene was determined from the human genome reference sequence (NCBI Build 36.1, chromosome 14, position 104,305,000- 104,334,000) and the reference transcript sequence of AKTl (GENBANK® accession number NM 005163). These sequences represent reference genomic and gene sequences for the AKTl transcription unit. A nucleotide sequence of the AKTl gene with position of 49G>A mutation denoted in parentheses is set forth as SEQ ID NO:2. In the wild type AKTl gene, G is present at position 49. In the mutant AKTl gene disclosed herein, A is present at position 49. An amino acid sequence of the AKTl protein with position of E17K mutation denoted in parentheses is set forth as SEQ ID NO: 1. In the wild type AKTl protein, E is present at position 17. In the mutant AKTl protein disclosed herein, K is present at position 17.

The AKTl (NM_005163) gene sequence is 1,443 nucleotides in length including the stop codon, and the AKTl (NP 005154) polypeptide is 480 amino acids in length.

Optimization of PCR primers:

The AKTl gene consists of 13 coding exons. Polymerase chain reaction (PCR) primer sequences were designed to amplify all 13 coding exons of the AKTl gene. Primer sequences were designed from flanking intronic sequences to allow the assessment of the sequence of the entire coding sequence of the AKTl gene in genomic DNA from clinical tumor specimens. The optimized primer sequences for amplifying the AKTl gene exons are listed in Table 3. To facilitate high throughput DNA sequencing an M 13 universal sequencing primer sequence was attached to both the forward and reverse primers for each target PCR region. Table 3. Optimized primers.

Exon and PCR product lengths are presented in nucleotide basepairs (bp)

PCR primers were synthesized (Invitrogen, USA) and were appropriately diluted for PCR. Individual primers are resuspended to a stock concentration of 100 micromolar. A ten micromolar working stock of a mix of forward and reverse primer pairs (primer mix) for each of the exons was made (5 micromolar each forward and reverse primer). Forward and reverse primer pairs for amplifying genomic regions encompassing each coding exon of the AKTl gene were optimized using thermocycler block gradient analysis to determine the optimal annealing temperature for amplification. The template DNA used in these optimization studies was a CEPH human reference DNA sample (CEPH 134702) purchased from the Coriell Institute for Medical Research. PCR was performed in 25 microliter reaction volumes with 10 nanograms of template DNA, PLATINUM® TAQ polymerase buffer, 2.0 millimolar MgCl₂, 1 millimolar deoxynucleotide triphosphates (dNTPs), 1 micromolar primer mix and 1 unit of PLATINUM® TAQ polymerase (Invitrogen, USA).

For gradient PCR primer optimization, PCR cycling conditions shown in Table 4 were used. Table 4. PCR cycling conditions for primer optimization

Successful primer design resulted in a clean and robust single PCR product (amplicon) of the appropriate molecular weight detected by analytical agarose gel electrophoresis. The optimal annealing temperature for the primers used are listed in Table 3. Mutational Analysis of Genomic DNA:

AKTl (NM 005163) exons and adjacent splice sites were amplified from genomic DNA. PCR amplicons were purified using AMPURE (Agencourt), sequenced using BigDye Terminator chemistry (Applied Biosystems) and separated on DNA analysers (ABI). Raw sequencing data were imported into Sequencher 4.2 (GeneCodes) for analysis. For each exon, normal CEPH sample 1347-02 germline DNA was sequenced and used as a reference along with the publicly available sequence.

PCR Amplification of AKTl exons:

This example describes the PCR conditions used to amplify AKTl exons from genomic DNA purified form human cancer cell lines (n=23) and human tumor specimens (50 breast, 50 colorectal tumors, 40 ovarian tumors, 80 lung tumors). Cell lines were propagated using the conditions recommended by the supplier. Approximately ten million cells were collected for each cell line and used for DNA extraction. For tumor tissue, two 25 milligram sections of tumor were used for DNA extraction. DNA was extracted from cell lines and tumor tissue using the QUIAMP® kit from Qiagen (Qiagen, Inc.) according to the manufacturer's recommended procedures. Typical DNA yields for cell lines were 25-40 micrograms of total DNA from 10 million cells. Typical DNA yields for tumors were approximately 1.5-2.0 micrograms per milligram of tissue section used in the extraction. A variety of measures were used for quality control of DNA including assessment of 260/280 ratios, restriction enzyme digestion, and PCR amplification using a standard set of well performing oligonucleotide primers. Stock solutions were placed in a -20⁰C freezer for long-term storage. Working stocks were diluted to 100 nanograms per microliter and stored at 4°C for molecular analysis.

PCR was performed in 25 microliter reaction volumes with 10 nanograms of template DNA, PLATINUM® TAQ polymerase buffer, 2.0 millimolar MgCl₂, 1 millimolar dNTPs, 1 micromolar primer mix and 1 unit of PLATINUM® TAQ polymerase (Invitrogen, USA). PCR was then carried out using the PCR conditions listed in Table 5. Table 5. PCR cycling conditions for AKTl exon amplicons

Sequencing of Amplicons Containing AKTl Exons:

Following PCR amplification, agarose gels were run to ensure amplification and to provide information on appropriate amounts of template used in subsequent sequencing reactions. PCR products were purified using the AMPURE® magnetic bead system (Agencourt, USA) following the standard protocols provided with the bead system. Varying amounts of purified PCR products (based on semiquantitative estimates of concentration based on agarose gel images) were used in cycle sequencing reactions using BIGD YE® Terminator chemistry (Applied Biosystems, USA). Cycle sequencing reactions contained 1 micromolar of either the forward or reverse universal M 13 primer, IX BIGD YE® Terminator mix and 10- 100 nanograms of PCR product template (amplicons containing AKTl exons). Cycle sequencing conditions used are shown in Table 6. Table 6. Cycle sequencing amplification conditions for AKTl exon PCR products

Following completion of the cycles, sequencing reactions were purified and subsequently run on ABI 3730XL DNA Analyzers. Bi-directional sequencing (forward and reverse) was performed for each PCR product in order to determine the sequence of both DNA strands for each sample to ensure proper base calling. Forward and reverse sequences for each sample for a given AKTl exon PCR product were imported into SEQUENCHER™ version 4.2 sequence analysis software (Gene Codes, USA). Experimentally derived sequences for each AKTl exon PCR product were aligned in SEQUENCHER™ along with a text reference file representing the appropriate exon. This text file was derived from the nucleotide sequence GENB ANK® accession number NM 005163 for human AKTl as described above. SEQUENCHER™ carries out a sequence alignment, displays the aligned sequences graphically (both as a chromatogram and as single letters for each nucleotide base), and highlights nucleotide base positions showing differences between any one sequence and all other sequences within that alignment project, allowing polymorphic variants and mutations to be easily recognized. The sequences were reviewed and the sites of mutation determined. Mutations were then mapped to the AKTl transcript to determine the amino acid substitutions in the sequence of the AKTl protein.

Analysis of AKTl Mutations in Human Cancer Cell Lines and Tumor Specimens: This example describes the analysis of mutations in DNA samples obtained from a series of human cancer cell lines (n=23) and human tumor specimens (50 breast, 50 colorectal tumors, 40 ovarian tumors, 80 lung tumors).

Twenty three human cancer cell lines and 220 human tumor specimens (50 breast, 50 colorectal tumors, 40 ovarian tumors, 80 lung tumors) were assed for novel mutations in the coding region of the AKTl gene. In a subset of human tumor specimens a mutation in the AKTl gene corresponding to nucleotide position 49 of SEQ ID NO:2 was found. This mutation was a substitution of adenine (A) for a guanine (G). An example chromatogram for this mutation is shown in Fig. 6. The mutation is highlighted in Fig. 6. This AKTl 49G to A gene mutation results in a nonconservative amino acid change of glutamic acid (E) to Lysine (K) at amino acid position 17 of the AKTl protein. The mutation results in replacement of a negatively charged amino acid (glutamic acid-E) with a positively charged amino acid (lysine-K). The frequency of this mutation was determined in different tumor types, the results of which are tabulated in Table 7.

The complete coding regions of AKT family members was evaluated for mutations in genomic DNA from clinical tumor specimens representing breast (n = 61 ), colorectal (n ^::: 51) and ovarian in ^::: 50) cancers. No genetic alterations were found in the catalytic domain of AKTl, AKT2 or AKT3 in breast, colorectal or ovarian clinical cancer specimens; however, further analysis of these samples revealed a unique mutation in the PHD of AK¹Tl. A G to A point mutation at nucleotide 49 that results in a lysine substitution for glutamic acid at amino acid 17 (AKT(EI 7K)) was identified in 5 of 61 (8%) breast, 3 of 51 (6%) colorectal ami 1 of 50 (2%) ovarian cancers (Table 7 and Fig. 8).

Table 7. Characteristics of tumors harboring the AKTl E17K mutation.

ER - Estrogen Receptor, PR - Progesterone Receptor, MSI - microsatellite instability, Neg - negative staining, Pos - positive staining, NA - data not available

DNA from normal adjacent tissue or white blood cells was sequenced to verity that the mutation, is somatic. The AKTl mutation is mutually exclusive with respect to mutations in P1K3CA and complete loss of PTEN protein expression (Table 9 and Fig. 7). Although the sample size was insufficient to document statistical significance, the lack of coincidence of these mutations indicates that the AKTl mutation is sufficient for pathological activation of the PI(3)K/AKT pathway. This mutation is not present in the Catalogue of Somatic Mutations in Cancer

(COSMIC available at the Sanger institute website) and was not revealed in a recent report of large-scale sequencing of approximately 13,000 genes in breast and colorectal cancers. Samples were quality controlled for sufficient mass and cancer content (>100 mg and >60% cancer); normal adjacent tissue or blood cells were analysed to verify somatic alterations.

The E17K mutation resides within the pleckstrin homology domain of AKTl, as shown in the schematic of the AKTl polypeptide (see for example Fig. 12). The pleckstrin homology domain of AKTl is believed to recruit AKTl to the plasma membrane by binding to phosphoinositides (PtdIns-3,4-P2 or PIP) which is believed to be required for AKTl activation.

Example 2 Screening of AKTl Mutations by Mass Spectrometry

This example describes a method of screening for mutations in the AKTl gene using mass spectrometry.

A PCR mass spectroscopy assay using the SEQUENOM® MAS S ARRAY® genotyping system was developed for screening for the 49G>A mutation in AKTl. This system is a fast and sensitive way for detecting variation and mutations in DNA or RNA. The SEQUENOM® MAS S ARRAY® system utilizes matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) and is an open platform that capitalizes on the inherent flexibility of SEQUENOM®' s IPLEX™ single base extension reaction. SEQUENOM® MASSARRA Y® Assay Design Software was used to design primers to be used in an IPLEX™ reaction. The primers used are provided in Table 8.

Table 8. Primer sequences developed for SEQUENOM® IPLEX™ assay to screen for the AKTl 49G>A in genomic DNA.

These primers were used in SEQUENOM® IPLEX™ reactions based on the manufacturer's recommendations. Results of AKTl 49G>A SEQUENOM® reactions are shown in Fig. 13A and 13B. Using mass spec analysis, the samples with the AKTl 49A mutation can be differentiated from samples with wild-type AKTl (49G)

Example 3 This example describes exemplary methods used in the following examples.

Immunohistochemical Analysis of Tumors:

A tumor-specific tissue microarray was constructed from paraffin blocks of breast cancers. Immunohistochemistry with PTEN antibody clone 6H2. lat 1 : 100 dilution (Cascade Biosciences Inc. Winchester, MA) was performed on tumor- specific tissue microarray sections, with deparaffinization and antigen retrieval performed on-line using the Bond-maX™ autostainer (Vision BioSystems™, Australia). Antibody staining was detected by Bond™ Polymer Refine Kit. Sections were visualized with 3,3'-diaminobenzidine, enhanced with copper sulphate and counterstained with haematoxylin.

Plasmids and Retrovirus Production:

Human full-length AKTl was subcloned into pcDNA3.1 (Invitrogen) or modified pJB02 with the amino-terminal Flag tag. AKT 1(E 17K) and AKT1(R25C) were generated by site-directed mutagenesis. AKTl PHD (amino acids 1-123) was subcloned into pEGFP-C 1 (Clontech) in which a six -residue N-terminal glycine linker had been inserted (Watton & Downward, Curr. Biol. 9, 433-436 (1999). pMSCV6-PGK/GFP, pMSCV6-AKTl-PGK/GFP, pMSCV6-AKTl(E17K)- PGK/GFP, and pMSCV6-myr-AKTl-PGK/GFP were derived from pMSCVneo (Hawley et al. Gene Ther. 1, 136-138 (1994) (Clontech, Mountain View, CA), with PGKeGFP replacing PGKneo. Murine Lck myristoylation sequence was fused to the N terminus of AKTl to generate Myr-AKTl . Ecotropic retrovirus was generated by co-transfecting pVPack-GP (Stratagene® ), pVPack-Eco (Stratagene®) and pMSCV6-AKTl-PGK/GFP or pMSCV6-myr-AKTl-PGK/GFP into HEK293T cells using FuGENE® 6 (Roche). Cells, Transfections and Antibodies: NIH 3T3 cells (ATCC) and Ratl cells (M. Marshall, Eli Lilly) were cultured in DMEM plus 10% calf serum or 10% fetal bovine serum (FBS), respectively, in 10% CO₂. Lysates from transiently transfected cells (Lipofectamine™, Invitrogen™) were prepared in lysis buffer consisting of 20 mM Tris buffer, 137 mM NaCl, 1 mM EGTA, 1% Triton-XIOO, 10% glycerol, 1.5 mM MgCl₂, 1 mM sodium vanadate, 1 mM Pefabloc (Roche), 1 mM dithiothreitol, 10 μg ml-1 leupeptin and 10 μg ml-1 aprotinin. Antibodies used as probes in western blots were: anti-Flag (M2) and β-actin (AC- 15) from Sigma; total AKT and P-AKT (Ser 473) from Cell Signaling Technology, Inc.; P-AKT (Thr 308) and anti-FKHRLl (pThr 32) from Upstate Biosource International (UBI); and anti-α-tubulin (TU-02) from Santa Cruz Biotechnology. Quantification and statistical analysis were with Total Lab software (Nonlinear Dynamics) and JMP 5.1 software (SAS Institute, Inc), respectively.

Kinetic Constants and Enzyme Activity: Flag-tagged AKTl constructs were expressed in HEK293E cells and protein purified by anti-Flag M2 agarose column (Sigma). Purified fractions were pooled, and AKTl confirmed by matrix-assisted laser desorption/ionization. Flag-tagged AKTl was activated with MAPKAP kinase 2 and PDKl kinase (UBI). Kinetic constants and kinase activity in the presence of AKT1/2 inhibitor VIII (Calbiochem) were determined using the K-LISA AKT activity kit (Calbiochem).

Immunoprecipitation:

Transfected NIH 3T3 cell lysates were mixed with anti-Flag antibody and protein G-sepharose. The beads were washed with lysis buffer and then divided for western blot analysis and AKT activity assays. For the activity assay, the beads were washed in K-LISA reaction buffer before re-suspending in 20 μl of 5 X K- LISA kinase buffer, 20 μl enzyme dilution buffer, 0.2 μg AKT substrate PRAS40 (Biomol) and 20 1 ATP/MgCl₂ mix (final concentration, 200 μM ATP and 15 rnM MgCl₂). Reactions were carried out at 30 ⁰C for 30 min. Phosphorylated PRAS40 was detected with the PRAS40 ELISA kit (Calbiochem) using anti-pPRAS40 (Thr 246) (UBI). Phosphoryiated AK T substrate w&s detected using anti-pPR AS40 (prolinc-rich AKT substrate) (Thr 246). Transfected NIH 3T3 cells were serum- starved before stimulation with 30 ng ml^"1 PDGF for 10 min. Cell fractionation was performed as described previously (Scheid et al. MoI. Cell. Biol. 22, 6247-6260, (2002)) with the following modifications: cells were washed with PBS supplemented with 200 nM sodium vanadate, membrane pellets were washed once with hypotonic buffer, and membrane pellets were solubilized in lysis buffer. Purity of the membrane fraction was assessed by western blot analysis with α-tubulin.

Live-cell Imaging:

NIH 3T3 cells were plated on cover glasses, transfected and serum-starved. Cells were pre-treated with LY294002 (Calbiochem) at 37 ⁰C for 10 min and/or stimulated with 37 ⁰C equilibrated PDGF (30 ng ml^"1) media. Cells were imaged every 30 s using a Leica DMI6000B inverted microscopeand analysed with FW4000 image acquisition software (Leica).

Example 4

Activation of AKTl by the E17K Mutation

This example describes effect of the E17K mutation on the enzymatic activity of AKT.

To assess the effects of the E17K mutation on AKTl regulation Flag-tag- fused AKTl(WT), AKT1(E17K) or AKT1(R25C) was expressed in NIH 3T3 cells. Unlike the R25C PHD, the E17K substitution resulted in an increased level of AKT phosphorylation on Thr 308 and Ser 473 compared to wild-type (Fig. 2A, Fig. 2C, lower panel). After immunoprecipitation with a Flag antibody, AKT 1(E 17K) kinase activity was approximately fourfold higher than that of AKTl (WT), and AKT1(R25C) kinase activity was significantly lower than that of AKTl(WT) (Fig. 2b). In whole-cell lysates the expression levels of AKTl(WT), AKT1(E17K) and AKT1(R25C) were similar (Fig. 2C, lower panel), whereas the amount of AKT 1(E 17K) and AKT1(R25C) immunoprecipitated by the Flag antibody was slightly less than AKTl(WT) (Fig. 2C, upper panel). Nevertheless, the level of AKT 1(E 17K) in vitro kinase activity was significantly higher than that of AKTl(WT) or AKT1(R25C), indicating that the E17K substitution alters AKTl regulation and enhances cellular activity. An increase in phosphorylation on the AKT substrate FKHRLl was observed in AKTl(E17K)-transfected cells compared to either vector-transfected or AKTl(WT)-transfected cells under serum-starved conditions (Fig. 2D, lanes 4-6) or in confluent cultures, but was not apparent in subconfluent cultures grown in 10% serum (Fig. 2D, lanes 1-3). These results indicate that AKT 1 (E 17K) upregulates survival signaling under adverse conditions. The kinetic properties of purified AKTl(WT) and AKT 1(E 17K) were assessed in an in vitro kinase assay using a synthetic peptide substrate, 'Crosstide'. Neither AKTl(WT) nor AKT 1(E 17K) had measurable in vitro kinase activity before activation by phosphorylation. After in vitro activation, the Michaelis constants (Km) for both ATP and Crosstide (Fig. 9B) were similar for AKT 1 (WT) and

AKT 1(E 17K), indicating that the increased activity of AKT 1(E 17K) observed in cells is not because the mutation changes the biochemical properties of the kinase, but probably reflects the increased phosphorylation of AKTl induced by the E17K mutation in the PHD . The sensitivity of activated AKT 1 (E 17K) to AKT 1 /2 inhibitor VIII, an inhibitor that does not compete with ATP or peptide, but does require the PHD(Barnett, et a Biochem. J. 385, 399-408 (2005)) was then examined. The half-maximal inhibitory concentrations (IC50 values) for AKT 1/2 inhibitor VIII for AKT1(E17K) and AKTl (WT) were 0.53 mM and 0.11 mM, respectively (Fig. 9C), whereas the IC50 values for ATP-competitive inhibitors were nearly identical. Hence, the E17K PHD mutation may result in structural changes in the PHD that alter its interaction with AKT 1/2 inhibitor VIII.

Example 5 E17K Alters the Subcellular Location of AKTl This example describes exemplary procedures for determining the effect of the E17K mutation on the subcellular location of AKT. Translocation of a green fluorescent protein (GFP)-AKTl PHD fusion protein from the cytoplasm to the plasma membrane is dependent on growth-factor- stimulation of serum- starved cells. To determine whether the E17K mutation alters protein localization, the position of GFP-tagged wild-type PHD (GFP- PH(WT)) or GFP-tagged E 17K PHD (GFP-PH(E 17K)) chimeric proteins was tracked by immunofluorescence. Under serum-starved conditions, GFP-PH(WT) was found in the cytoplasm and nucleus, but rapidly translocated to the plasma membrane on platelet-derived growth factor (PDGF) stimulation (Fig. 3A). In contrast, GFP- PH(E 17K) was localized to the plasma membrane in the absence of serum stimulation and was only slightly stimulated by PDGF (Fig. 3A). A GFP-tagged R25C PHD (GFP-PH(R25C)) was found throughout the cell, including the membrane and cytoplasm, and did not translocate to the plasma membrane on PDGF stimulation. The PI(3)K inhibitor LY294002 inhibited PDGF-stimulated translocation of GFP-PH(WT) to the plasma membrane; however, this inhibitor had minimal effect on the localization of GFP-PH(E 17K) either in the absence or in the presence of PDGF stimulation (Fig. 3A). The E17K mutation seems to abrogate the requirement of the AKTl PHD for D3-phosphorylated phosphoinositides for inducing membrane association, as GFP- PH(E 17K) is still detected at the plasma membrane when membrane levels of PtdIns(3,4,5)P3 or PtdIns(3,4)P2 are low. The localization and activation of full-length AKT 1 (E 17K) was assessed by biochemical fractionation of NIH 3T3 cells that transiently express Flag-tagged AKT 1(E 17K). Western blot analysis revealed that both AKTl(WT) and AKT 1(E 17K) were found at the plasma membrane under serum-starved conditions, although the highest fraction of both proteins was in the cytoplasm (Fig. 3B). Under serum-starved conditions, the level of membrane-associated AKT phosphorylated at Thr 308 and Ser 473 (P-AKT) was more than 4.5-fold higher in the AKTl(E17K)-transfected cells than that in the AKTl(WT)-transfected cells (Fig. 3B and Fig. 10). The increased level of P-AKT Thr 308 or Ser 473 in AKT1(E17K) compared to AKTl(WT) in the membrane fractions of the serum-starved cells is not entirely caused by the nominal increase in the level of Flag tag detected in these lysates.

Thus, the E17K mutation not only facilitates membrane localization but also results in increased phosphorylation of AKT in the absence of serum. PDGF stimulation of both AKTl(WT)-transfected and AKTl(E17K)-transfected cells activates AKT phosphorylation at Thr 308 and Ser 473 to nearly the same extent, which indicates that the mutation does not alter the normal physiological response to growth factors. Moreover, the results are consistent with the concept that AKTl activation is linked to positional information and indicate that the increased kinase activity associated with AKT 1(E 17K) may be owing to an increased presence at the plasma membrane.

Example 6 Transformation Studies The example describes the procedures used to demonstrate the transformation potential of mutant AKT 1(E 17K).

To assess whether the E17K mutation is sufficient to transform, Ratl cells were infected with retroviral constructs that encode Myr-AKTl, AKTl(WT) or AKT 1(E 17K). Ratl cells were transduced with titred viral supernatant plus 8 μg ml-1 diethylaminoethyl dextran hydrochloride (Fluka). Seventy-two hours after transduction, cells were split into 100-mm dishes for foci formation or for anchorage-independent growth by seeding 5X10⁴ cells per 60-mm Petri dish in 0.33% Bacto agar, 6.7% Bacto tryptose phosphate broth (Becton-Dickinson), 10% FBS and DMEM. Brightfϊeld and fluorescent images were taken on an inverted Nikon microscope fitted with a Spot camera. Foci developed on the AKT 1(E 17K) and Myr-AKTl infected cells 15 days after cells were confluent (Fig. 4A Fig. 11), and soft agar colonies were observed 25 days after initial infections (Fig. 4B). No foci were observed either on the control vector or on the control AKTl(WT) plates, nor were soft agar colonies detected on the control vector plates. Only five colonies were apparent on the AKTl(WT) plates. In contrast, the introduction of AKTl

(E 17K) and Myr-AKTl resulted in generation of 43 and 61 colonies, respectively. These constructs contain a GFP reporter gene, and the soft agar colonies that were observed in these assays expressed GFP (Fig. 4C). Increased levels of P-AKT Ser 473 and Thr 308 were found in several AKTl(E17K)-expressing or Myr-AKTl - expressing clones compared to control vector- or AKTl(WT)-infected cells (Fig. 4D). Sequence analysis confirmed the expression of each transgene, Myr-AKTl, AKTl(WT) or AKT 1(E 17K), as expected for each clone. The E17K mutation transformed cells in culture, consistent with our initial hypothesis that this mutation is oncogenic in human cancers. AKT 1(E 17K) induces leukemia in mice Adoptive transfer of embryonic liver hematopoietic stem cells from the Em-Myc transgenic mouse (TgN(IgH-Myc)22Bri) modified to express the murine anti-apoptotic protein Bcl2, the eukaryotic initiation factor 4E (eIF4E) or Myr-AKTl rapidly induce B- cell lymphomas.

Example 7 Mouse Leukemia Model This example describes procedures for the generation of leukemia in mice with hematopoietic stem cells transfected with viral particle encoding mutant AKT1(E17K).

To determine that expression of the human AKT 1(E 17K) allele could induce leukemia similar to Myr-AKTl, Cells from pooled embryonic Em-Myc livers were mock-transduced, or transduced with a retroviral vector that expresses AKT 1 (WT), Myr-AKTl or AKT 1(E 17K), in addition to a GFP reporter gene. Single-cell suspensions were derived from livers of embryonic day (E)16.5-E18.5 embryos from C57BL/6J X C57BL/6JTg(IgH-Myc)22Bri/J matings. Freshly isolated cells were placed in hematopoietic stem cell media (Iscove's modified Dulbecco's media with 1-glutamine, 25 mM HEPES, 55 μM 2-mercaptoethanol, penicillin/streptomycin, 20% FBS, and the following recombinant murine proteins: 2 ng mf¹ interleukin-6, 100 ng mP¹ stem cell factor, 100 ng mP¹ thrombopoietin and 100 ng mP¹ fms-like tyrosine kinase-3 ligand) and transduced with fresh or frozen retroviral supernatants of various constructs in the presence of 8 μg mf¹ diethylaminoethyl dextran hydrochloride for 4 hours. Approximately 3 X 10⁶ cells were injected into lethally irradiated C57BL/6J hosts (700 rad followed at 3 hours by 400 rad). Flow cytometry of nucleated peripheral blood cells showed increasing P- AKT Ser 473 and/or GFP fluorescence signals over time in Myr-AKTl and AKT 1(E 17K) animals; however, neither AKTl(WT) nor mock transduction animals showed any P-AKT Ser 473 or GFP above background levels in C57BL/6J mice (Fig. 5A and 5B). All of the Myr-AKT transduced mice developed leukemia, whereas six out often of the AKT(E 17K) mice and none of the AKTl(WT) mice developed leukemia. The fraction of mice that developed leukemia (E17K versus wild-type) was statistically significant in both Wilcoxon and log-rank analysis (both P50.0041 and P50.047, respectively). The leukemic cells from AKT 1(E 17K) mice were 20-30 mm in diameter, had basophilic cytoplasm, and had nuclei with an irregular folded to- cleaved morphology and generally inconspicuous nucleoli: cyto logical characteristics of lymphoblasts (Fig. 5C). The E17K leukemic blasts are slightly B220+ CDl lb+ and CD3-, consistent with a pre-pro-B-cell leukemia, and express GFP and P-AKT Ser 473. In contrast, the Myr-AKT blasts are B220+, but CDl Ib- and CD3- negative, consistent with a more mature B-cell leukemia. Expression of AKT 1(E 17K) and Myr-AKT was confirmed by sequence analysis of RNA from lysed nucleated cells. For the P-AKT-GFP assay, nucleated cells from the blood of rescued animals were fixed, permeabilized and stained with anti-P-AKT Ser 473 antibody (Cell Signaling) according to the manufacturer's recommended protocol. Flow cytometry was performed on cells following a secondary stain with R-phycoerythrin-conjugated anti-rabbit Ig antibody (BioSource).

Example 8 Crystallographic Analysis

This example describes the procedures used to obtain the molecular cooridinates of AKT 1 (WT) PHD and AKT 1 (E 17K) PHD in the apo form and in complex with Ins(l,3,4,5)P₄.

El 7K alters the conformation of the AKTl PHD. The binding of phosphoinositides to the PHD activates AKT 1. In the apo conformation, GIu 17 occupies the phosphoinositide-binding pocket and forms a network of hydrogen bonds (Milburn et ah, Biocheni. J. 375, 531-538 (2003). Entry of the

Ptdlns(3,4,5)P3 and PtdIns(3,4)P2 inositol head groups disrupts this conformation, thus GIu 17 has a pivotal role in AKTl activation. Disclosed herein is the solved the crystal structures of wild-type and E17K PHDs from human AKTl to 1.1 A and 1.9 A resolution, respectively, as well as the El 7K PHD-Ins{ 1 ,3,4,5)P4 complex to 2.6 A resolution, In the apo conformation, acidic GIu 17 forms an ionic interaction with basic Lys 14 in the pocket (Mi (bum el aLBiochem. J. 375, 531-538 (2003) (Fig. IA the line represents the interaction); however, in the case of the Lys 17 substitution in E 17K PHD, the positively charged Lys 17 cannot interact with Lys 14 (Fig, 1 B). Moreover, the Lys 17 substitution results in a shift in the surface charge around the pocket from negative with GIu 17 to effectively neutral in the mutant (Supplementary FIg. 3). To accommodate the inositol head group in. the wild-type PHD, GIu 17 swings down and away (4.7 A) from the pocket, as does Tyr 18

(Protein Data Bank code: I UNQ), In the El 7K PHD, Tyr 18 moves 7.5 A out of the pocket and forms a hydrogen bond with Lys 17. Additional hydrogen bonds form between Lys 17, a conserved water molecule and the 5-phosphate and 6-hydroxyl of ins(l ,3,4,5)P4 (Fig. 1 C). Lys 17 could enhance the affinity or decrease the off-rate of D5~phosphorylated phosphoinositides for AKTl, or both. Notably, the PHD of phosphoinositide- dependent protein kinase 1 (PDKl; also called PDPKI) contains a lysine at the position homologous to GIu 17 in AKTl, and PDKl, unlike AKTl, shows higher affinity for Ptdlns(3,4,5)P3 than for PtdIns(3,4)P2 (refs 23-25).

Crystals of AKTl(WT) PHD apo and AKT 1(E 17K) PHD apo were grown in 0.1 M HEPES pH 7.5 and 1.4 M sodium citrate for one week (80 X 80 X 100 μm). Co-crystals of AKT1(E17K) and Ins(l,3,4,5)P4 were grown in 0.1 M sodium acetate (pH 4.6), 0.2 M ammonium acetate and 25 ± 5% poly(ethylene glycol) 3350 for one week (80 X 80 X 100 μm). Crystals were grown from hanging drops and frozen in liquid nitrogen with the cryo-protectant 25% glycerol. Data were collected at the Argonne National Laboratory, Industrial Macromolecular Crystallography

Association, beam line 17-ID at 1 lambda and 100 K. Ramachandran statistics for E17K APO and E17K_P4-inositol are as follows: residues in favored regions, 93.9, 87.6; additional allowed regions, 4.0, 10.5; generously allowed regions, 1.0, 1.0; and disallowed regions, 1.0, 1.0, respectively. The data collection and refinement statistics are shown in Table 9.

Table 9. Data collection and refinement statistics (Molecular replacement)

Data collection

Space group C 1 2 1 C 1 2 1

Cell dimensions a, b, c (A) 83.9 32.8 42.2 79.3,32.7 42.0 α, β, γ (°) 90.0 119.1 90.0 90.0 116.7 90.0

Resolution (A) 1.94 A (high res. shell) 2.45 A (high res. shell) R sym or R merge 0.139 (hi; gh res. shell) 0.132 (high res. shell) i/σl 2.1 (high res. shell) 13.5 (high res. shell)

Completeness (%) 86.4 (high res. shell) 88.9 (high res. shell)

Redundancy 2.0 (high res. shell) 2.5 (high res. shell)

Refinement

Resolution (A) 1.94 2.46

No. reflections 6956 3647

R work/ R free 0.207/0.286

No. atoms

Protein 956 985

Ligand/ion n/a 28

Water 50 40

B -factors

Protein 30.9 26.658

Ligand/ion n/a 21

Water 27 25

R.m.s deviations

Bond lengths (A) 0.005 0.012

Bond angles (°) 0.877 1.542

* one-crystal/structure .

* Highest resolution shell is shown in parenthesis.

It will be apparent that the precise details of the methods or compositions described may be varied or modified without departing from the spirit of the described invention. We claim all such modifications and variations that fall within the scope and spirit of the claims below.

Claims

1. A method for diagnosing or predicting a predisposition to develop a cancer in a subject, comprising: obtaining a sample from the subject comprising a nucleic acid encoding a polypeptide comprising an amino acid sequence set forth as SEQ ID NO: 1; detecting a polymorphism in a nucleic acid encoding v-akt murine thymoma viral oncogene homo log 1 (AKTl) polypeptide in the sample obtained form the subject, wherein detecting the polymorphism comprises detecting the presence of a mutation in an AKTl polypeptide at amino acid position 17 of SEQ ID NO: 1, wherein the presence of the polymorphism indicates that the subject has a cancer or has a predisposition to develop the cancer.

2. The method of claim 1 , wherein the polymorphism is a substitution of lysine for glutamic acid at amino acid position 17 of SEQ ID NO: 1.

3. The method of claim 1, wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as nucleic acid residues 45- 53 of SEQ ID NO:2.

4. The method of claim 1 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:2

5. The method of claim 1 , wherein the nucleic acid encoding the AKT 1 polypeptide comprises a nucleic acid sequence set forth as ID NO:32.

6. The method of claim 1 , wherein the polymorphism is a G to A transition at position 49 in SEQ ID NO:2.

7. The method of claim 1 , wherein detecting the polymorphism comprises the use of restriction digestion, probe hybridization, nucleic acid amplification, nucleotide sequencing, mass spectrometry, or a combination thereof.

8. The method of claim 1, wherein the cancer is an adenocarcinoma or cancer of the reproductive organs.

9. The method of claim 18, wherein the cancer is colorectal cancer or lung cancer.

10. The method of claim 18, wherein the cancer of the reproductive organs is breast cancer or ovarian cancer.

11. A method of determining the prognosis of a subject having or suspected of having cancer, comprising : obtaining a sample from the subject comprising a nucleic acid encoding a polypeptide comprising an amino acid sequence set forth as SEQ ID NO: 1; detecting a polymorphism in a nucleic acid encoding v-akt murine thymoma viral oncogene homo log 1 (AKTl) polypeptide in the sample obtained from the subject, wherein detecting the polymorphism comprises detecting the presence of a mutation in an AKTl polypeptide at amino acid position 17 of SEQ ID NO: 1, wherein the detection of the polymorphism in the sample is indicative of the prognosis of cancer in the subject.

12. The method of claim 11 , wherein the polymorphism is a substitution of lysine for glutamic acid at position 17 of SEQ ID NO: 1.

13. The method of claim 11 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as nucleic acid residues 45-53 of SEQ ID NO:2.

14. The method of claim 11 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:2

15. The method of claim 11 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:32.

16. The method of claim 11 , wherein the polymorphism is a G to A transition at position 49 in SEQ ID NO:2.

17. The method of claim 11 , wherein detecting the polymorphism comprises the use of restriction digestion, probe hybridization, nucleic acid amplification, nucleotide sequencing, mass spectrometry, or a combination thereof.

18. The method of claim 11 , wherein the cancer is an adenocarcinoma or cancer of the reproductive organs.

19. The method of claim 18, wherein the cancer is colorectal cancer or lung cancer.

20. The method of claim 18, wherein the cancer of the reproductive organs is breast cancer or ovarian cancer.

21. A method of detecting the presence of breast, colorectal, or ovarian cancer in a subject, comprising obtaining a sample from the subject comprising a nucleic acid encoding a polypeptide comprising an amino acid sequence set forth as SEQ ID NO: 1; and determining whether the nucleic acid encodes a polypeptide comprising a glutamic acid or a lysine at position 17 of SEQ ID NO: 1; wherein the presence of a lysine at position 17 of SEQ ID NO: 1 indicates that the subject has breast, colorectal or ovarian cancer.

22. The method of claim 21 , wherein determining whether the nucleic acid encodes a polypeptide comprising a glutamic acid or a lysine at position 17 comprises the use of restriction digestion, probe hybridization, nucleic acid amplification, nucleotide sequencing, mass spectrometry, or a combination thereof.

23. The method of claim 21 , wherein the polymorphism is a substitution of lysine for glutamic acid at position 17 of SEQ ID NO: 1.

24. The method of claim 21 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as nucleic acid residues 45-53 of SEQ ID NO:2.

25. The method of claim 21 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:2

26. The method of claim 21 , wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:32.

27. The method of claim 21 , wherein the polymorphism is a G to A transition at position 49 in SEQ ID NO:2.

28. The method of claim 21 , wherein detecting the polymorphism comprises the use of restriction digestion, probe hybridization, nucleic acid amplification, nucleotide sequencing, mass spectrometry, or a combination thereof.

29. The method of claim 21 , wherein the cancer is an adenocarcinoma or cancer of the reproductive organs.

30. The method of claim 29, wherein the cancer is colorectal cancer or lung cancer.

31. The method of claim 29, wherein the cancer of the reproductive organs is breast cancer or ovarian cancer.

32. A method for determining if an agent of interest is of use for treating cancer, comprising contacting an isolated cell comprising an AKTl polypeptide comprising amino acids 8-108 of SEQ ID NO: 2, wherein amino acid 17 is a lysine with the agent of interest; detecting the AKTl polypeptide; and determining if the agent of interest inhibits the localization of the AKTl polypeptide to the plasma membrane of the cell, wherein inhibition of the localization of the AKTl polypeptide to the plasma membrane of the cell relative to a control identifies the agent as of use for treating cancer.

33. The method of claim 32, wherein the isolated cell is contacted with the agent under conditions of serum starvation.

34. The method of claim 32, further comprising contacting the isolated cell with platelet derived growth factor.

35. The method of claim 32, further comprising: lysing the isolated cell; isolating the plasma membrane fraction of the lysed cell; and detecting the presence of the AKTl polypeptide in the plasma membrane fraction of the lysed cell, wherein a reduction in the amount of the AKTl polypeptide in the plasma membrane fraction relative to a control identifies the agent as of use for treating cancer.

36. The method of claim 32, wherein the control is a standard value or an isolated cell not contacted with the agent.

37. The method of claim 32, wherein the AKTl polypeptide is detected with an antibody that specifically binds AKTl .

38. A method for determining if an agent of interest is of use for treating cancer, comprising: contacting an isolated cell comprising an AKTl polypeptide comprising amino acids 8-108 of SEQ ID NO: 2, wherein amino acid 17 is a lysine with the agent of interest; detecting the AKTl polypeptide; and determining if the agent of interest inhibits the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308 relative to a control, wherein inhibition of the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308 relative to the control identifies the agent as of use for treating cancer.

39. The method of claim 38, wherein the isolated cell is contacted with the agent under conditions of serum starvation.

40. The method of claim 38, further comprising contacting the isolated cell with platelet derived growth factor.

41. The method of claim 38, wherein the control is a standard value or an isolated cell not contacted with the agent.

42. The method of claim 38, wherein the AKTl polypeptide is detected with an antibody that specifically binds AKTl phosphorylated at one or more of Ser 473 or Thr 308.

43. A method for determining if a subject with cancer is resistant to treatment with a v-akt murine thymoma viral oncogene homo log 1 (AKTl) inhibitor, comprising: obtaining a sample from the subject comprising a nucleic acid encoding a polypeptide comprising an amino acid sequence set forth as SEQ ID NO: 1; detecting a polymorphism in a nucleic acid encoding v-akt murine thymoma viral oncogene homo log 1 (AKTl) polypeptide in the sample obtained from the subject, wherein detecting the polymorphism comprises detecting the presence of a mutation in an AKTl polypeptide at amino acid position 17 of SEQ ID NO: 1, wherein the detection of the polymorphism in the sample indicates that the subject is resistant to treatment with the AKTl inhibitor.

44. The method of claim 43, wherein the polymorphism is a substitution of lysine for glutamic acid at amino acid position 17 of SEQ ID NO: 1.

45. The method of claim 43, wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as nucleic acid residues 45-53 of SEQ ID NO:2.

46. The method of claim 43, wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:2

47. The method of claim 43, wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:32.

48. The method of claim 43, wherein the polymorphism is a G to A transition at position 49 in SEQ ID NO:2.

49. The method of claim 43, wherein detecting the polymorphism comprises the use of restriction digestion, probe hybridization, nucleic acid amplification, nucleotide sequencing, mass spectrometry, or a combination thereof.

50. The method of claim 43, wherein the cancer is an adenocarcinoma or cancer of the reproductive organs.

51. The method of claim 50, wherein the cancer is colorectal cancer or lung cancer.

52. The method of claim 50, wherein the cancer of the reproductive organs is breast cancer or ovarian cancer.

53. The method of claim 43, further comprising determining whether the subject is homozygous or heterozygous for the polymorphism.

54. The method of claim 43, wherein the treatment comprises the use of a triazole compound, a pyrazolylamine substituted quinazoline compound, pyrazole compound, an indazole compound, a fused pyrimidyl pryrazole compound, a heterocyclic compound or an isoxazole compound.

55. A method for determining if a subj ect with cancer would benefit from treatment with an agent that inhibits the localization of a v-akt murine thymoma viral oncogene homo log 1 (AKTl) polypeptide to the plasma membrane of a cell or inhibits the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308, comprising: obtaining a sample from the subject comprising a nucleic acid encoding a polypeptide comprising an amino acid sequence set forth as SEQ ID NO: 1; detecting a polymorphism in a nucleic acid encoding AKTl polypeptide in the sample obtained from the subject, wherein detecting the polymorphism comprises detecting the presence of a mutation in an AKTl polypeptide at amino acid position 17 of SEQ ID NO: 1, wherein the detection of the polymorphism in the sample indicates that the subject would benefit from treatment with an agent that inhibits the localization of the AKTl polypeptide to the plasma membrane of a cell or inhibits the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308.

56. The method of claim 55, wherein the polymorphism is a substitution of lysine for glutamic acid at amino acid position 17 of SEQ ID NO: 1.

57. The method of claim 55, wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as nucleic acid residues 45-53 of SEQ ID NO:2.

58. The method of claim 55, wherein the nucleic acid encoding the

AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:2

59. The method of claim 55, wherein the nucleic acid encoding the AKTl polypeptide comprises a nucleic acid sequence set forth as ID NO:32.

60. The method of claim 55, wherein the polymorphism is a G to A transition at position 49 in SEQ ID NO:2.

61. The method of claim 55 , wherein detecting the polymorphism comprises the use of restriction digestion, probe hybridization, nucleic acid amplification, nucleotide sequencing, mass spectrometry, or a combination thereof.

62. The method of claim 55, wherein the cancer is an adenocarcinoma or cancer of the reproductive organs.

63. The method of claim 62, wherein the cancer is colorectal cancer or lung cancer.

64. The method of claim 62, wherein the cancer of the reproductive organs is breast cancer or ovarian cancer.

65. The method of claim 55, further comprising determining whether the subject is homozygous or heterozygous for the polymorphism.

66. The method of claim 55, wherein the agent that inhibits the localization of the AKTl polypeptide to the plasma membrane is identified by the method of claim 32.

67. The method of claim 55, wherein the agent that inhibits the phosphorylation of the AKTl polypeptide at one or more of Ser 473 or Thr 308 is identified by the method of claim 38.