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CompletedNCT01349933Updated Dec 5, 2017Results posted

Akt Inhibitor MK2206 in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

A Phase 2 interventional study of Akt inhibitor MK2206 in Recurrent Squamous Cell Carcinoma of the Nasopharynx and Stage IV Squamous Cell Carcinoma of the Nasopharynx, sponsored by National Cancer Institute (NCI). Completed at 8 sites in 3 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-12-05.

Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
21
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase II trial is studying how well Akt inhibitor MK2206 works in treating patients with recurrent or metastatic head and neck cancer. Akt inhibitor MK2206 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Read the detailed description

PRIMARY OBJECTIVES:

I. To determine the proportion of patients alive and progression-free at 6 months along with the confirmed response rate as a dual primary endpoint..

SECONDARY OBJECTIVES:

I. To evaluate best response and duration of response for patients treated with MK2206 (Akt inhibitor MK2206).

II. To evaluate the overall survival and progression-free survival (PFS) of patients treated with MK2206.

III. To evaluate safety and tolerability of MK2206.

TERTIARY OBJECTIVES:

I. To evaluate the pharmacokinetics of MK2206 in Asian patients. II. To study the pharmacodynamic effect of MK2206 using biomarkers and correlation with cancer-related outcomes.

OUTLINE: This is a multicenter study.

Patients receive Akt inhibitor MK2206 orally (PO) on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample collection at baseline and periodically during study for pharmacogenomic and pharmacokinetic studies.

After completion of study therapy, patients are followed up for up to 3 years.

02

Conditions studied

  • Recurrent Squamous Cell Carcinoma of the Nasopharynx
  • Stage IV Squamous Cell Carcinoma of the Nasopharynx
03

In context

Carcinoma

6,741 studies on the registry are indexed under Carcinoma; 1,163 are open to participants now.

This study's enrollment of 21 is below the median of 45 across 5,174 interventional studies indexed under Carcinoma.

Browse Carcinoma studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.

Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Histologically or cytologically confirmed non-keratinizing nasopharyngeal carcinoma that has recurred at locoregional and/or distant sites, and is not amenable to potentially curative radiotherapy or surgery
  • Measurable disease according to the RECIST criteria
  • Progressed =\< 24 months of receiving one or two prior line(s) of chemotherapy for recurrent disease, of which at least one line must contain platinum drugs such as cisplatin, carboplatin or oxaliplatin
  • ECOG performance status 0, 1, or 2
  • Hemoglobin >= 9 g/dL
  • ANC >= 1,500/μL
  • Platelet count >= 100,000/μL
  • Total bilirubin =\< 2.5 times upper limit of normal (ULN)
  • ALT =\< 2.5 times ULN (=\< 5 times ULN for patients with liver metastases)
  • Creatinine =\< 1.5 times ULN OR creatinine clearance >= 60 mL/min/1.73 m\^2
  • Ability to understand and the willingness to sign a written informed consent document
  • Willingness to donate blood for mandatory correlative research studies
  • Negative (serum) pregnancy test done =\< 7 days prior to registration, for women of childbearing potential only

Exclusion criteria

Exclusion Criteria:

  • Any of the following

    • Chemotherapy =\< 4 weeks prior to registration
    • Radiotherapy =\< 4 weeks prior to registration
    • Nitrosoureas or Mitomycin C =\< 4 weeks prior to registration
    • Those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
    • NOTE: Prior palliative radiotherapy to bone metastases is allowed =\< 4 weeks prior to registration
  • Prior investigational agents =\< 4 weeks prior to registration
  • Symptomatic brain metastases; NOTE: primary nasopharyngeal cancers that directly invade the skull base and extend into the infratemporal fossa(e) are not regarded as brain metastases and are not excluded
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to MK-2206 or other agents used in the study
  • Prior potent and moderate inhibitors and inducers of CYP3A4 =\< 2 weeks prior to registration:

    • Drugs that are forbidden, potent inducers of CYP3A4: phenytoin, phenobarbitone, carbamazepine, barbiturate, rifampicin, St John's Wort.
    • Drugs that significantly affect metabolizing activity by way of enzyme inhibition of CYP3A4: ketoconazole, itraconazole, fluconazole, indinavir, ritonavir, erythromycin, cimetidine, clarithromycin
  • Unwillingness to go off other inducers and inhibitors of CYP3A4 during the first 2 cycles of MK-2206; NOTE: avoiding these drugs is critical during the first 2 cycles of MK-2206when blood samples are being taken for the correlative study unless there is an urgent medical need and alternatives are not available
  • Poorly controlled diabetes mellitus or insulin controlled diabetes; NOTE: As a general guide, patients with a fasting glucose level > 150 mg/dL (HbA1c \<8%, > 8.3 mmol/L), or a random glucose level of >180mg/dL (> 10 mmol/L) is considered to have inadequately controlled diabetes and are not eligible for this study; however, such patients can become eligible in the future if their fasting glucose levels improve with medical treatment
  • QTc prolongation (defined as a QTc interval > 450 msec for males and >470 msec for females) or other significant ECG abnormalities; NOTE: patients with clinically significant cardiac conduction abnormalities should be excluded, these include left bundle branch block (LBBB), 2nd or 3rd degree AV block, bifascicular block, sick sinus syndrome, Wolff-Parkinson-white syndrome, sinus bradycardia (\< 50bpm); however, patients with asymptomatic right bundle branch block (RBBB) or 1st degree AV block, in the absence of known cardiac disease (e.g. coronary, valvular) are not excluded
  • Uncontrolled intercurrent illness including, but not limited to:

    • Ongoing or active infection,
    • Symptomatic congestive heart failure,
    • Unstable angina pectoris,
    • Uncontrolled symptomatic cardiac arrhythmia,
    • Psychiatric illness/social situations that would limit compliance with study requirements
  • Diagnosed to have any of the following condition(s), and/or have undergone any one of the following procedure(s) =\< 3 months prior to registration:

    • Symptomatic thrombotic or hemorrhagic cerebral vascular accident
    • Coronary bypass graft
    • Angioplasty
    • Myocardial infarction
  • Patients having continuing >= grade 2 adverse events (excluding alopecia) due to agents (chemotherapy or radiotherapy) administered > 4 weeks prior to registration based on Common Terminology Criteria for Adverse Events (CTCAE version 4.0) =\< grade 1
  • Any of the following:

    • Pregnant women
    • Nursing women
    • Men or women of childbearing potential who are unwilling to employ adequate contraception
    • NOTE: because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with MK-2206, breastfeeding should be discontinued if the mother is treated with MK-2206; women of childbearing potential and men must use two forms of contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation
  • HIV-positive patients on combination antiretroviral therapy; NOTE: HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with MK-2206; in addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy
  • Recent major surgery =\< 4 weeks prior to registration (excluding the placement of vascular access), or minor surgery =\< 2 weeks prior to registration
  • Any condition (e.g., gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, prior surgical procedures affecting absorption) that impairs patients ability to swallow MK-2206 tablets
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
21 participants (actual)

Study arms

  • Experimental
    Treatment (Akt inhibitor MK2206)

    Patients receive 200 mg Akt inhibitor MK2206 PO on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

    Drug: Akt inhibitor MK2206

Interventions

  • DrugAkt inhibitor MK2206

    Given PO

    Also known as: MK2206

06

What researchers measure

Primary outcomes

  1. Proportion of Patients Alive and Progression-free

    The primary endpoint of this trial is the proportion of patients alive and progression-free at 6 months. Progression status is evaluated using RECIST version 1.1. A Progression is defined as either: At least one new malignant lesion, which also includes any lymph node that was normal at baseline (less than 1.0 cm short axis) and increased to greater than or equal to 1 cm short axis during follow up. Or, at least a 20% increase in sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes.

    Time frame: 6 months

  2. Confirmed Response Rate Defined to be a CR or PR Noted as the Objective Status on 2 Consecutive Evaluations at Least 4 Weeks Apart

    Evaluated using RECIST version 1.1. A Complete Response (CR) requires disappearance of all target lesions and each target lymph node must have reduction in short axis to \<1.0 cm. A Partial Response (PR) requires at least a 30% decrease in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes at current evaluation. The confirmed response rate is reported as the number of participants with confirmed responses divided by the number of evaluated participants.

    Time frame: 6 months

Secondary outcomes

  1. Adverse Events Associated With the Agent Graded Based on CTCAE Version 4.0

    The maximum grade for each type of adverse event will be recorded for each patient, and frequency tables will be reviewed to determine adverse event patterns. Only the severe or worse adverse events will be assessed, regardless of relationship to the study treatment. The number of patients reporting a grade 3 or higher event were counted.

    Time frame: Up to 30 days after completion of study treatment

  2. Overall Survival

    Estimated using the method of Kaplan-Meier.

    Time frame: From registration to death due to any cause, assessed up to 3 years

  3. Progression-free Survival

    Progression-free survival is defined as the time from registration to the time of progression or death, whichever occurs first. Estimated using the method of Kaplan-Meier.

    Time frame: From registration to the first of either death due to any cause or progression, assessed up to 3 years

  4. Best Response (Complete Response vs Partial Response vs Stable Disease vs Progression)

    Evaluated using RECIST version 1.1. A Complete Response (CR) requires disappearance of all target lesions and each target lymph node must have reduction in short axis to \<1.0 cm. A Partial Response (PR) requires at least a 30% decrease in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes at current evaluation. Progressive Disease (PD) is defined as either a new lesion of a 20% increase in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes. Stable Disease (SD) is defined as not having a PD, CR, or PR.

    Time frame: Up to 3 years

  5. Duration of Response

    Duration of response is defined for all evaluable patients who have achieved an objective response as the date at which the patient's objective status is first noted to be either a CR or PR to the date progression is documented.

    Time frame: The date at which the patient's objective status is first noted to be either a CR or PR to the date progression is documented, assessed up to 3 years

07

Results

Posted Jan 8, 2015

Participant flow

Participant flow — Overall Study
MilestoneTreatment (Akt Inhibitor MK2206)
Started21
Completed21
Not completed0

Outcome measures

PrimaryProportion of Patients Alive and Progression-free

The primary endpoint of this trial is the proportion of patients alive and progression-free at 6 months. Progression status is evaluated using RECIST version 1.1. A Progression is defined as either: At least one new malignant lesion, which also includes any lymph node that was normal at baseline (less than 1.0 cm short axis) and increased to greater than or equal to 1 cm short axis during follow up. Or, at least a 20% increase in sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes.

Time frame:
6 months
Reported as:
Number · participants
Proportion of Patients Alive and Progression-free
participantsTreatment (Akt Inhibitor MK2206)
Alive and Progression Free9
Dead or Progression12
PrimaryConfirmed Response Rate Defined to be a CR or PR Noted as the Objective Status on 2 Consecutive Evaluations at Least 4 Weeks Apart

Evaluated using RECIST version 1.1. A Complete Response (CR) requires disappearance of all target lesions and each target lymph node must have reduction in short axis to \<1.0 cm. A Partial Response (PR) requires at least a 30% decrease in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes at current evaluation. The confirmed response rate is reported as the number of participants with confirmed responses divided by the number of evaluated participants.

Time frame:
6 months
Reported as:
Number · percentage of participants
Confirmed Response Rate Defined to be a CR or PR Noted as the Objective Status on 2 Consecutive Evaluations at Least 4 Weeks Apart
percentage of participantsTreatment (Akt Inhibitor MK2206)
Complete Response0
Partial Response4.8
SecondaryAdverse Events Associated With the Agent Graded Based on CTCAE Version 4.0

The maximum grade for each type of adverse event will be recorded for each patient, and frequency tables will be reviewed to determine adverse event patterns. Only the severe or worse adverse events will be assessed, regardless of relationship to the study treatment. The number of patients reporting a grade 3 or higher event were counted.

Time frame:
Up to 30 days after completion of study treatment
Reported as:
Count of participants · Participants
Adverse Events Associated With the Agent Graded Based on CTCAE Version 4.0
ParticipantsTreatment (Akt Inhibitor MK2206)
Grade 3+ Adverse Event13
Grade 4+ Adverse Event0
SecondaryOverall Survival

Estimated using the method of Kaplan-Meier.

Time frame:
From registration to death due to any cause, assessed up to 3 years
Reported as:
Median · months
Overall Survival
monthsTreatment (Akt Inhibitor MK2206)
Overall Survival10.0 (5.9 to 20.0)
SecondaryProgression-free Survival

Progression-free survival is defined as the time from registration to the time of progression or death, whichever occurs first. Estimated using the method of Kaplan-Meier.

Time frame:
From registration to the first of either death due to any cause or progression, assessed up to 3 years
Reported as:
Median · months
Progression-free Survival
monthsTreatment (Akt Inhibitor MK2206)
Progression-free Survival3.5 (0.9 to 7.3)
SecondaryBest Response (Complete Response vs Partial Response vs Stable Disease vs Progression)

Evaluated using RECIST version 1.1. A Complete Response (CR) requires disappearance of all target lesions and each target lymph node must have reduction in short axis to \<1.0 cm. A Partial Response (PR) requires at least a 30% decrease in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes at current evaluation. Progressive Disease (PD) is defined as either a new lesion of a 20% increase in the sum of the longest diameter for all target lesions plus the sum of the short axis of all the target lymph nodes. Stable Disease (SD) is defined as not having a PD, CR, or PR.

Time frame:
Up to 3 years
Reported as:
Count of participants · Participants
Best Response (Complete Response vs Partial Response vs Stable Disease vs Progression)
ParticipantsTreatment (Akt Inhibitor MK2206)
Stable Disease11
Partial Response (PR)1
Cmplete Response (CR)0
Progressive Disease9
SecondaryDuration of Response

Duration of response is defined for all evaluable patients who have achieved an objective response as the date at which the patient's objective status is first noted to be either a CR or PR to the date progression is documented.

Time frame:
The date at which the patient's objective status is first noted to be either a CR or PR to the date progression is documented, assessed up to 3 years

No measurements were reported for this outcome.

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Treatment (Akt Inhibitor MK2206)—10/21 (47.6%)19/21 (90.5%)
Most frequent serious events
Showing 10 of 22
Most frequent serious events
EventTreatment (Akt Inhibitor MK2206)
FeverGeneral disorders3/21
ConstipationGastrointestinal disorders2/21
DysphagiaGastrointestinal disorders2/21
Skin infectionInfections and infestations2/21
HyperglycemiaMetabolism and nutrition disorders2/21
VertigoEar and labyrinth disorders1/21
ConjunctivitisEye disorders1/21
Dry mouthGastrointestinal disorders1/21
GastritisGastrointestinal disorders1/21
Stomach painGastrointestinal disorders1/21
Most frequent other events
Showing 10 of 49
Most frequent other events
EventTreatment (Akt Inhibitor MK2206)
Rash maculo-papularSkin and subcutaneous tissue disorders12/21
FatigueGeneral disorders9/21
Dry skinSkin and subcutaneous tissue disorders5/21
ConjunctivitisEye disorders4/21
DiarrheaGastrointestinal disorders4/21
VomitingGastrointestinal disorders4/21
FeverGeneral disorders4/21
Upper respiratory infectionInfections and infestations4/21
Weight lossInvestigations4/21
AnorexiaMetabolism and nutrition disorders4/21

Baseline characteristics

Age, Continuous
Age, Continuous(years)Treatment (Akt Inhibitor MK2206)
Median47 (32 to 67)
Sex: Female, Male
Sex: Female, Male(Participants)Treatment (Akt Inhibitor MK2206)
Female2
Male19
Region of Enrollment
Region of Enrollment(participants)Treatment (Akt Inhibitor MK2206)
Singapore9
Hong Kong12
08

Study locations

8 sites
  • University of Iowa Hospitals and Clinics
    Iowa City, Iowa 52242, United States
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Metro-Minnesota CCOP
    Saint Louis Park, Minnesota 55416, United States
  • Washington University School of Medicine
    Saint Louis, Missouri 63110, United States
  • Chinese University of Hong Kong-Prince of Wales Hospital
    Shatin, Hong Kong OX1 3UJ, China
  • National University Hospital
    Singapore, 119074, Singapore
  • National Cancer Centre
    Singapore, 169610, Singapore
  • Johns Hopkins Singapore International Medical Centre
    Singapore, 308433, Singapore
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 5, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01349933
Lead sponsor
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
May 9, 2011
Start date
Apr 2011
Primary completion
Oct 2013
Completion
Oct 2013
Results posted
Jan 8, 2015
Last update
Dec 5, 2017

Study contacts

Brigette Ma
principal investigator · Mayo Clinic
View the source record on ClinicalTrials.gov ↗

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