Advanced Gastric Adenocarcinoma Clinical Trial
Phase II trial of AZD5363 plus paclitaxel / AZD2014 plus paclitaxel in biomarker negative
(PIK3CA/MEK/RAS/TP53/MET) advanced gastric adenocarcinoma patients as second-line
chemotherapy.
Each arm is composed of 25 patients.
AZD5363 400mg bid 4 days on/ 3 days off of a 7 day cycle for each week that paclitaxel is
given + paclitaxel 80mg/m2 given days 1, 8 and 15 of a 28 day cycle. AZD5363 and paclitaxel
will be received for 3 consecutive weeks, followed by one week off-therapy in 4-week
cycles.If paclitaxel therapy is stopped then AZD5363 can be given on a 4on/3off continuous
schedule.
AZD2014 50mg BD 3 days on 4 days off of a 7 day cycle + paclitaxel 80mg/m2 given days 1, 8
and 15 of a 28 day cycle.
Tumour evaluation using Response Evaluation Criteria in Solid Tumors 1.1 will be conducted at
screening (within 28 days prior to first dose) and every 8 weeks relative to the date of
first dose, up to week 40, then every 16 weeks until objective disease progression (within a
window of +/- 7 days of the scheduled date).
Study treatment will be continued until objective disease progression.
The purpose of this study is to investigate the safety and efficacy of AZD5363 plus
paclitaxel in biomarker negative (PIK3CA/MEK/RAS/TP53/MET) advanced gastric adenocarcinoma
patients as second-line chemotherapy.
AZD2014 is a selective dual mTOR kinase inhibitor targeting both mTORC1 (rapamycin sensitive)
and mTORC2 (rapamycin insensitive) complexes of mammalian Target of Rapamycin (mTOR).
AZD2014 is a selective dual mTOR kinase inhibitor targeting both mTORC1 (rapamycin sensitive)
and mTORC2 (rapamycin insensitive) complexes of mammalian Target Of Rapamycin (mTOR) AZD2014
is specific for mTOR and does not inhibit other members of the PI3K superfamily.
The PI3K-AKT-mTOR pathway functions as a sensor of mitogen, energy and nutrient levels and is
a central controller of cell growth.
The mTOR is a protein kinase (PK) and a vital component of the PI3K/Akt/mTOR signaling
pathway. This pathway is deregulated in 50% of all human cancers and, as such, is an
important target for inhibitors that would alleviate the unregulated proliferation of cancer
cells . AZD2014 is selective inhibitor of mTOR kinases and inhibits signalling of both mTOR
complexes, mTORC1 and mTORC2.
In this study, the researchers further investigated the effect of PI3K/mTOR inhibitor as a
paclitaxel sensitizer and/or nonspecific targeted therapy in combination with standard
chemotherapy, paclitaxel in patients with pretreated advanced or metastatic gastric cancer
having all negative biomarkers (PIK3CA/MEK/RAS/TP53/MET).
AZD5363 is a highly potent adenosine triphosphate (ATP)-competitive AKT inhibitor with
IC50<10nmol/l for all three AKT isoforms.
AZD5363 is a highly potent adenosine triphosphate (ATP)-competitive AKT inhibitor with
IC50<10nmol/l for all three AKT isoforms. AKT pathway is activated in various human
cancers.Although AKT inhibitor has known showing anti-tumor activity in cell lines mutated at
the E542, E545, or H1047 positions in preclinical study, clinical studies with AKT inhibitor
are conducted for non-selected cancer patients.
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