Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Phase 1 Dose Escalation Study of ARQ 092 in Adult Subjects With Advanced Solid Tumors and Recurrent Malignant Lymphoma

Summary: This is an open-label, Phase 1, dose escalation study of oral ARQ 092 administered to subjects with advanced solid tumors and recurrent malignant lymphoma. The study is designed to explore the safety, tolerability, pharmacokinetics, and pharmacodynamics of ARQ 092 and to define a recommended Phase 2 dose of ARQ 092.


Eligibility: Inclusion Criteria:
  1. Men or women ≥18 years old
  2. Histologically or cytologically documented, incurable, locally advanced or metastatic solid tumors or recurrent malignant lymphoma in subjects who failed standard therapy or for whom standard or curative therapy does not exist or is not tolerable.
  3. Evaluable or measurable disease
  4. Life expectancy greater than three months
  5. ECOG performance status ≤2
  6. Hemoglobin (Hgb) ≥9.5 g/dl
  7. Absolute neutrophil count (ANC) ≥1.5 x 10^9/L
  8. Platelet count ≥75 x 10^9/L
  9. Total bilirubin ≤1.5 × upper limit of normal (ULN)
  10. Aspartate transaminase (AST) and alanine transaminase (ALT) ≤3 × ULN
  11. Serum creatinine ≤1.5 x ULN or creatinine clearance > 60 mL/min/1.73 m^2 for subjects with creatinine levels >1.5 x ULN
  12. Agree to use double-barrier contraceptive measures or avoid intercourse during the study and for 90 days after the last dose of study drug
  Exclusion Criteria:
  1. History of Type 1 or 2 diabetes mellitus requiring regular medication (other than metformin or other oral hypoglycemic agents) or fasting glucose ≥160 mg/dL at the prestudy visit. If a diabetic cohort is enrolled, only subjects with a medical history of controlled Type 1 or 2 diabetes mellitus will be enrolled in the cohort.
  2. Grade 2 or worse hypercholesterolemia or hypertriglyceridemia or >8% glycated Hb (HbA1C)
  3. Malabsorption syndrome
  4. Known brain metastases not radiographically stable for ≥3 months or leptomeningeal disease
  5. History of myocardial infarction (MI) or NYHA Class II-IV congestive heart failure within 6 months of the administration of the first dose of ARQ 092 (MI occurring >6 months of the first dose of ARQ 092 will be permitted); Grade 2 or worse conduction defect (eg right or left bundle branch block); left ventricular ejection fraction (LVEF) < 50% assessed by echocardiogram/MUGA scan
  6. Anti-cancer chemotherapy, radiotherapy, immunotherapy, or investigational agents within four weeks of the first dose of ARQ 092 (within 2 weeks for orally administered drugs)
  7. Major surgery within four weeks of the first dose of ARQ 092
  8. Previous treatment with AKT inhibitors
  9. Concurrent severe uncontrolled illness not related to cancer
  10. Ongoing or active known infection, including human immunodeficiency virus (HIV) infection or bleeding
  11. Psychiatric illness/substance abuse/social situation that would limit compliance with study requirements.
  12. Blood transfusion within 5 days prior to blood draw being used to confirm eligibility
  13. Pregnant or breastfeeding
  14. Previous other malignancy within 2 years prior to the first dose of ARQ 092, with the exception of carcinoma in-situ of the cervix, basal cell carcinoma and superficial bladder tumors curatively treated.

Relevance to patient case: not relevant