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Phase I trial of Ipatasertib plus Atezolizumab enhances PI3K/AKT pathway immune responses in solid tumors and refractory glioblastoma.

Clinical cancer research : an official journal of the American Association for Cancer Research 2026 🔓 OA Cancer Immunotherapy and Biomarkers
OpenAlex 토픽 · Cancer Immunotherapy and Biomarkers PI3K/AKT/mTOR signaling in cancer CAR-T cell therapy research

Tiu C, Yau W, Silva D, Waldron N, Ameratunga M, Scaranti M, Biondo A, Welsh L, Creak A, Jones TL, Martin AJ, Bridges L, Zachariou A, Crespo M, Ferreira A, Riisnaes R, Gurel B, Figueiredo I, Bogdan D, Yuan W, Morilla R, Swales K, Decordova S, Prout T, Parmar M, Baikady B, Rata M, Blackledge M, Tunariu N, Benjamin P, Rich P, Daly R, Hu X, Yap C, Vivanco I, Paschalis A, Sharp A, Banerji U, Minchom A, de Bono J, Lopez J

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[PURPOSE] Activation of the phosphatodylinositol-3-kinase/AKT (PI3K/AKT) signalling pathway promotes tumor immune evasion by suppressing effector T-cell infiltration and enhancing regulatory T-cell ac

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APA Crescens Tiu, Wing Yau, et al. (2026). Phase I trial of Ipatasertib plus Atezolizumab enhances PI3K/AKT pathway immune responses in solid tumors and refractory glioblastoma.. Clinical cancer research : an official journal of the American Association for Cancer Research. https://doi.org/10.1158/1078-0432.CCR-25-4364
MLA Crescens Tiu, et al.. "Phase I trial of Ipatasertib plus Atezolizumab enhances PI3K/AKT pathway immune responses in solid tumors and refractory glioblastoma.." Clinical cancer research : an official journal of the American Association for Cancer Research, 2026.
PMID 42043781

Abstract

[PURPOSE] Activation of the phosphatodylinositol-3-kinase/AKT (PI3K/AKT) signalling pathway promotes tumor immune evasion by suppressing effector T-cell infiltration and enhancing regulatory T-cell activity contributing to resistance to immune checkpoint inhibitors. Preclinical studies have demonstrated that inhibition of this pathway can restore anti-tumor immunity and synergize with PD-1/PD-L1 blockade. We explore the synergistic clinical potential of targeting the PI3K/AKT pathway in combination with atezolizumab to overcome immunotherapy resistance in recurrent glioblastoma and advanced solid tumors.

[EXPERIMENTAL DESIGN] Phase 1b, investigator-initiated, open-label study (NCT03673787) composed of a proof-of-concept dose escalation Part A of ipatasertib plus atezolizumab in a 3+3 design. Adult patients with treatment refractory advanced cancers were enrolled into Cohort A1 and recurrent glioblastoma onto Cohort A2. Part B enrolled patients into 6 exploratory cohorts. Study aims to evaluate the safety, immune-modulatory effects and preliminary efficacy of the combination of ipatasertib with atezolizumab.

[RESULTS] The combination was well tolerated, with no dose-limiting toxicities at the recommended phase 2 dose of ipatasertib 400 mg/daily plus atezolizumab 1200mg every 3 weeks. Pharmacodynamic analysis demonstrated depletion of FOXP3+ regulatory T cells and increased infiltration of CD8+ effector T cells within the tumor microenvironment. Durable exceptional responses were seen in some patients with treatment-refractory or recurrent glioblastoma.

[CONCLUSION] This is the first report in clinical samples showing that ipatasertib efficiently depletes FOXP3+ regulatory T cells and results in increased infiltration of effector CD8+ T cells in the tumor microenvironment. This was associated with preliminary efficacy in a subset of patients with treatment-refractory glioblastoma (GBM).