Phase 1 trial of the oral AKT inhibitor MK-2206 plus carboplatin/paclitaxel, docetaxel, or erlotinib in patients with advanced solid tumors.

Abstract

BACKGROUND:

Inhibition of AKT with MK-2206 has demonstrated synergism with anticancer agents. This phase 1 study assessed the MTD, DLTs, PK, and efficacy of MK-2206 in combination with cytotoxic and targeted therapies.

METHODS:

Advanced solid tumor patients received oral MK-2206 45 or 60 mg (QOD) with either carboplatin (AUC 6.0) and paclitaxel 200 mg/m2 (arm 1), docetaxel 75 mg/m2 (arm 2), or erlotinib 100 or 150 mg daily (arm 3); alternative schedules of MK-2206 135-200 mg QW or 90-250 mg Q3W were also tested.

RESULTS:

MTD of MK-2206 (N = 72) was 45 mg QOD or 200 mg Q3W (arm 1); MAD was 200 mg Q3W (arm 2) and 135 mg QW (arm 3). DLTs included skin rash (arms 1, 3), febrile neutropenia (QOD, arms 1, 2), tinnitus (Q3W, arm 2), and stomatitis (QOD, arm 3). Common drug-related toxicities included fatigue (68%), nausea (49%), and rash (47%). Two patients with squamous cell carcinoma of the head and neck (arm 1; Q3W) demonstrated a complete and partial response (PR); additional PRs were observed in patients (1 each) with melanoma, endometrial, neuroendocrine prostate, NSCLC, and cervical cancers. Six patients had stable disease ≥6 months.

CONCLUSION:

MK-2206 plus carboplatin and paclitaxel, docetaxel, or erlotinib was well-tolerated, with early evidence of antitumor activity.

• Authors: L Rhoda Molife, Li Yan, Joanna Vitfell-Rasmussen, Adriane M Zernhelt, Daniel M Sullivan, Philippe A Cassier, Eric Chen, Andrea Biondo, Ernestina Tetteh, Lillian L Siu, Amita Patnaik, Kyriakos P Papadopoulos, Johann S de Bono, Anthony W Tolcher, Susan Minton
• Journal: Journal of hematology & oncology (J Hematol Oncol) Vol. 7 Pg. 1 (Jan 03 2014) ISSN: 1756-8722 [Electronic] England
• PMID: 24387695 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Heterocyclic Compounds, 3-Ring
• MK 2206
• Quinazolines
• Taxoids
• Docetaxel
• Carboplatin
• Erlotinib Hydrochloride
• Proto-Oncogene Proteins c-akt
• Paclitaxel

Topics

• Administration, Oral
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Area Under Curve
• Carboplatin (administration & dosage, adverse effects)
• Docetaxel
• Dose-Response Relationship, Drug
• Erlotinib Hydrochloride
• Exanthema (chemically induced)
• Fatigue (chemically induced)
• Febrile Neutropenia (chemically induced)
• Female
• Heterocyclic Compounds, 3-Ring (administration & dosage, adverse effects, pharmacokinetics)
• Humans
• Male
• Middle Aged
• Nausea (chemically induced)
• Neoplasms (classification, drug therapy, metabolism)
• Paclitaxel (administration & dosage, adverse effects)
• Proto-Oncogene Proteins c-akt (antagonists & inhibitors, metabolism)
• Quinazolines (administration & dosage, adverse effects)
• Stomatitis (chemically induced)
• Taxoids (administration & dosage, adverse effects)
• Tinnitus (chemically induced)
• Treatment Outcome
• Young Adult