MK2206 in Treating Patients With Stage I, Stage II, or Stage III Breast Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT01319539
First received: March 18, 2011
Last updated: July 9, 2014
Last verified: July 2014
  Purpose

This phase II trial is studying how well MK2206 works in treating patients with stage I, stage II, or stage III breast cancer. MK2206 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.


Condition Intervention Phase
Estrogen Receptor-negative Breast Cancer
Estrogen Receptor-positive Breast Cancer
HER2-negative Breast Cancer
HER2-positive Breast Cancer
Progesterone Receptor-negative Breast Cancer
Progesterone Receptor-positive Breast Cancer
Stage IB Breast Cancer
Stage II Breast Cancer
Stage IIIA Breast Cancer
Stage IIIB Breast Cancer
Stage IIIC Breast Cancer
Triple-negative Breast Cancer
Drug: Akt inhibitor MK2206
Procedure: therapeutic conventional surgery
Other: diagnostic laboratory biomarker analysis
Other: pharmacological study
Procedure: neoadjuvant therapy
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Pre-surgical Evaluation of MK-2206 in Patients With Operable Invasive Breast Cancer

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Change in phospho-Akt (Ser473) levels [ Time Frame: Baseline and day 0 ] [ Designated as safety issue: No ]
    A Wilcoxon signed-rank matched-pairs test will be used to compare expression levels in paired pre- and post-MK-2206 tissue.


Secondary Outcome Measures:
  • PI3K/AKT expression [ Time Frame: Up to 4 weeks ] [ Designated as safety issue: No ]
    The Spearman rank correlation coefficient will be used to analyze any relationship between the expression levels of different biomarkers. The Wilcoxon signed-rank (matched-pairs) test will be used to compare expression levels between matched pre-and post-treatment samples. All p-values will be two-sided with statistical significance evaluated at the 0.05 alpha level. Ninety-five percent confidence intervals will be calculated to assess the precision of the obtained estimates. All analyses will be performed in SAS version 9.2 and STATA version 9.0.

  • KI-67 expression [ Time Frame: Up to 4 weeks ] [ Designated as safety issue: No ]
    The Spearman rank correlation coefficient will be used to analyze any relationship between the expression levels of different biomarkers. The Wilcoxon signed-rank (matched-pairs) test will be used to compare expression levels between matched pre-and post-treatment samples. All p-values will be two-sided with statistical significance evaluated at the 0.05 alpha level. Ninety-five percent confidence intervals will be calculated to assess the precision of the obtained estimates. All analyses will be performed in SAS version 9.2 and STATA version 9.0.

  • Toxicity assessed using NCI CTCAE version 4.0 [ Time Frame: Up to 4 weeks ] [ Designated as safety issue: Yes ]
  • Biologic response to treatment [ Time Frame: Up to 4 weeks ] [ Designated as safety issue: No ]

Enrollment: 12
Study Start Date: April 2011
Primary Completion Date: July 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients receive Akt inhibitor MK2206 PO on days -9 and -2, and undergo segmental resection or total mastectomy on day 0.
Drug: Akt inhibitor MK2206
Given PO
Other Name: MK2206
Procedure: therapeutic conventional surgery
Undergo surgery
Other: diagnostic laboratory biomarker analysis
Correlative studies
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies
Procedure: neoadjuvant therapy
Given PO

Detailed Description:

PRIMARY OBJECTIVES:

I. Assess for a decrease in phospho-Akt (Ser^473) levels in tissue after a pre-surgical trial of weekly protein Kinase B (Akt) inhibitor MK2206 (MK2206) (2 doses) in patients with operable invasive breast cancer.

SECONDARY OBJECTIVES:

I. Evaluate the effects of MK2206 on the immunohistochemical expression of other PI3K/AKT pathway biomarkers on pre-and post-MK2206 tumor tissue, such as phospho-S6 kinase.

II. Assess modulation of PI3K/AKT signaling following MK2206 use with reverse-phase protein microarray analysis.

III. Explore whether PIK3CA mutations demonstrate different modulation of PI3K/Akt-pathway signaling as compared to tumors with loss of phosphatase and tensin homolog(PTEN).

IV. Explore whether MK2206 alters PI3K/Akt pathway signaling differently in hormone receptor-positive/human epidermal growth factor receptor (HER)2-negative tumors, as compared to triple-negative or HER2-positive breast cancers.

V. Evaluate whether tumor proliferation, as measured by Ki-67 staining of breast tumor cells, is reduced in patients taking MK2206 pre-surgically and correlate Ki-67 modulation with changes in PI3K/AKT signaling.

VI. Determine safety and tolerability of MK2206 in patients with early-stage breast cancer.

VII. Collect fasting blood for evaluation of predictive markers of drug effect, such as markers in the insulin growth-factor receptor pathway (i.e., fasting insulin, c-peptide, insulin-like growth factor (IGF)-1, and IGF binding protein (BP)-1 and 3), as well as modulation of phospho-markers in peripheral blood mononuclear cells.

OUTLINE: This is a multicenter study.

Patients receive Akt inhibitor MK2206 orally (PO) on days -9 and -2, and undergo segmental resection or total mastectomy on day 0.

After completion of therapy, patients are followed up for 4 weeks.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have histologically confirmed operable, invasive adenocarcinoma of the breast and have undergone core-needle biopsy with an anticipated surgical resection for residual disease after enrollment
  • Clinical stage IB-IIIC invasive breast (invasive tumor must be >= T1c by radiograph or palpation)
  • Patients must have available tissue from core biopsies for biomarker assessment

    • It is recommended that at least 4 cores be performed with 12-gauge (or smaller gauge) needles, including cores underneath ultrasound-guidance
  • Patients planning to undergo surgical treatment with either segmental resection or total mastectomy required
  • Patients may have a history of contralateral breast cancer, provided there is no evidence of recurrence of the initial primary breast cancer
  • Patients must agree to biomarker assessment of pre-treatment diagnostic core-biopsy tissue and the surgical resection tissue (i.e., excision or mastectomy) and also agree to pre- and post-treatment fasting blood biomarker collection
  • Patients may not have any known evidence of distant metastatic disease (i.e., lung, liver, bone, or brain metastases) or locally recurrent breast cancer
  • No inflammatory breast cancer
  • Estrogen receptor, progesterone receptor, and human epidermal growth factor (HER)2 positive or negative
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 (Karnofsky PS 80-100%)
  • Menopausal status not specified
  • White blood cell count (WBC) >= 3,000/μL
  • Platelet count >= 100,000/μL
  • Hemoglobin >= 9 g/dL
  • Creatinine =< 1.5 times upper limit of normal (ULN)
  • Prothrombin time (PT) and partial thromboplastin time (PTT) =< 1.2 times ULN
  • Total bilirubin =< 1.5 times ULN
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2.5 times ULN
  • Negative pregnancy test
  • Women of childbearing potential must use two forms of contraception (hormonal, barrier method of birth control, or abstinence) prior to study entry and for the duration of study participation
  • Not pregnant or nursing
  • Patient must be able to swallow oral tablets
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to Akt inhibitor MK2206 used in the study
  • No known diabetes that is poorly controlled (glycosylated hemoglobin [HBA1C] >= 8%)
  • No baseline QTc > 470 msec
  • No baseline bundle branch block
  • No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection,symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • No concurrent combination antiretroviral therapy for human immunodeficiency virus (HIV)-positive patients
  • More than 6 months since prior chemotherapy or radiotherapy
  • Concurrent metformin allowed provided patient has been taking it for > 3 months
  • No prior neoadjuvant therapy
  • No other concurrent investigational agents, including other inhibitors of PI3K, Akt, or mammalian target of rapamycin (mTOR)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01319539

Locations
United States, New York
Albert Einstein College of Medicine
Bronx, New York, United States, 10461
Montefiore Medical Center - Moses Campus
Bronx, New York, United States, 10467-2490
Columbia University Medical Center
New York, New York, United States, 10032
Sponsors and Collaborators
Investigators
Principal Investigator: Kevin Kalinsky Montefiore Medical Center - Moses Campus
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01319539     History of Changes
Other Study ID Numbers: NCI-2011-02513, NCI-2011-02513, CDR0000696821, AECM-AAAF3912, 8740, P30CA013330, N01CM62204
Study First Received: March 18, 2011
Last Updated: July 9, 2014
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases

ClinicalTrials.gov processed this record on July 22, 2014