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  • A phase I trial of MK-2206 ...
    Mehnert, Janice M.; Kaveney, Amanda D.; Malhotra, Jyoti; Spencer, Kristen; Portal, Daniella; Goodin, Susan; Tan, Antoinette R.; Aisner, Joseph; Moss, Rebecca A.; Lin, Hongxia; Bertino, Joseph R.; Gibbon, Darlene; Doyle, Laurence A.; White, Eileen P.; Stein, Mark N.

    Cancer chemotherapy and pharmacology, 10/2019, Letnik: 84, Številka: 4
    Journal Article

    Purpose Given the evidence that coordinate inhibition of AKT induces autophagy, we studied the combination of the AKT inhibitor, MK-2206 with hydroxychloroquine (HCQ) in patients with advanced solid tumors. Methods Patients were treated with weekly MK-2206 (135 mg or 200 mg) plus HCQ (200 mg, 400 mg or 600 mg BID). Results Thirty-five patients were enrolled across 5 dose levels. Two DLTs of grade 3 maculo-papular rash were observed at dose level 2 (MK-2206 200 mg weekly plus HCQ at 400 mg BID) and 1 DLT of grade 3 fatigue at dose level 2B (MK-2206 135 mg weekly plus HCQ 600 mg BID). The maximum tolerated dose (MTD) was declared as dose level 2B. The most common adverse events attributed to MK-2206 were hyperglycemia ( N  = 18; 51%), fatigue ( N  = 17; 49%), maculo-papular rash ( N  = 16; 46%), diarrhea ( N  = 12; 34%), anorexia ( N  = 11; 31%), and nausea ( N  = 11; 31%). Patients experiencing adverse events attributed to HCQ were small in number ( N  = 13) and primarily included fatigue ( N  = 5; 14%) and maculo-papular rashes ( N  = 3; 9%). Statistically significant effects on the pharmacokinetic properties of MK-2206 were observed in combination with HCQ. In addition, the plasma concentrations of HCQ in the combination with MK-2206 were significantly higher than the plasma levels of HCQ as monotherapy in prior studies. The best overall response of stable disease was observed in 5/34 (15%) patients. Conclusion The combination of MK-2206 and hydroxychloroquine was tolerable, but with substantial number of drug-related AEs and minimal evidence of antitumor activity.