The phosphoinositide 3-kinase (PI3K)͞Akt pathway controls a vast array of normal physiological processes and is frequently aberrantly activated in cancer, thus identifying PI3K͞Akt-signaling components as promising drug targets in oncology. However, implementation of rational cancer therapies for this pathway needs robust and simple tools to stratify patients according to PI3K pathway activation and to validate and measure the impact of targeted inhibition on primary cancer tissues. Herein we present a technique for the quantification of the PI3K͞Akt-signaling pathway based on the mass spectrometric measurement of PI3K-dependent protein kinase activity in cell lysates. The concept of this application of MS is to exploit enzymatic activity to amplify the signal of the enzyme under study analogous to the PCR used to amplify nucleic acid sequences. We show that this approach allows quantitative analysis of a cell-signaling pathway with high sensitivity, precision of quantification, and specificity. Due to its special analytical capabilities and potential for multiplexing, this approach could contribute significantly to cell-signaling studies and to the development and implementation of personalized cancer therapies.quantitative analysis ͉ signaling pathway ͉ personalized therapies ͉ cancer stem cells ͉ patient stratification S ignal transduction pathways downstream of receptor tyrosine kinases control a large array of biological processes, including energy metabolism, cell proliferation, survival, cell motility, and immune responses. One of these pathways, the phosphoinositide 3-kinase (PI3K)͞Akt axis, is one of the most frequently deregulated pathways in cancer (1-4) by virtue of oncogenic mutation, by overexpression of its signaling components (5-8), by inactivation of the PTEN tumor-suppressor protein, which opposes PI3K action (9-12), or by being at the crossroads of upstream oncogenic signals (reviewed in ref. 4).Because of the importance of this pathway in the control of several biological and pathological processes (13-15), robust methods to quantify its activation are needed. PI3K catalyzes the phosphorylation of the lipid phosphatidylinositol-4,5-bisphosphate to form phosphatidylinositol-3,4,5-trisphosphate, a second messenger that is needed for the activation of downstream Ser͞Thr kinase protein kinases, such as Akt [also known as protein kinase B (PKB)] and phosphoinositide-dependent kinase-1. The assessment of lipid production by various approaches has turned out to be cumbersome, and it is thus far not possible to directly measure production of phosphatidylinositol-3,4,5-trisphosphate in tissue samples. Activation of the PI3K pathway is therefore commonly assessed by examination of signaling components downstream of PI3K. These components include Akt͞PKB and kinases farther downstream of the Akt͞PKB cascade, such as p70-S6K. Most often, this examination is performed by indirect assessment using immunochemical methods that measure the phosphorylation status of Akt on Ser-473 or Thr-308 or of S6, a ribos...