What is the latest AKT (Anti-cancer treatment) regimen?

Clarification Required: "AKT" Context is Ambiguous

The acronym "AKT" in your question requires clarification, as the provided evidence addresses two completely different medical contexts:

If You Mean: Anti-Tuberculosis Treatment (ATT/AKT)

I cannot provide a recommendation as none of the evidence provided addresses tuberculosis treatment regimens. The evidence exclusively discusses AKT as a protein kinase in cancer biology.

If You Mean: AKT Pathway Inhibitors for Cancer Treatment

For cancer patients with documented AKT pathway activation, capivasertib (AZD5363) represents the most clinically advanced AKT inhibitor with FDA approval for specific indications, particularly in breast cancer with PIK3CA, AKT1, or PTEN alterations. 1

Current Clinical Landscape of AKT Inhibitors

FDA-Approved Therapy

• Capivasertib is FDA-approved for hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer with PIK3CA, AKT1, or PTEN biomarker alterations 1
• This represents the only regulatory-approved AKT pathway inhibitor with defined biomarker-driven indications 1

Tumor-Specific Applications

Meningiomas with AKT1 E17K Mutations:

• AKT1 p.E17K mutations occur in approximately 10% of meningiomas, typically in WHO grade 1 anterior/middle skull base, NF2-wildtype tumors 1
• Capivasertib showed activity across multiple tumor types harboring AKT1 p.E17K mutations in basket trial studies 1
• Molecular testing for AKT1 mutations should guide treatment selection in recurrent meningiomas after standard options are exhausted 1

Endometrial Cancer:

• PTEN and PIK3CA mutations are extremely common in endometrial cancer 1
• The combination of everolimus (mTOR inhibitor) plus letrozole showed 24% response rates in recurrent disease, with 53% responses in chemotherapy-naive patients 1
• Notably, three patients with AKT1 mutations demonstrated significantly increased progression-free survival and response rates with mTOR inhibition 1
• Single-agent mTOR inhibitors show modest activity (<25% response rates) without consistent correlation to PTEN or PIK3CA alterations 1

Colorectal Cancer:

• Multiple AKT pathway inhibitors have demonstrated efficacy in preclinical models, including Perifosine (AKT inhibitor) and PI103 (PI3K inhibitor) 1, 2

Combination Strategies

• Combining AKT inhibitors with MEK/ERK inhibitors blocks compensatory pathway activation and shows particular efficacy in KRAS or BRAF mutant tumors 2
• This approach addresses the interconnected nature of the PI3K/AKT and RAS/RAF/MEK/ERK pathways 1

Biomarker-Guided Selection

Predictive Biomarkers for AKT Inhibitor Response:

• PTEN loss strongly predicts response to AKT pathway inhibitors 2
• Pathway activation markers (phospho-AKT, phospho-S6K) can guide therapy selection 2
• Specific mutations: AKT1 p.E17K, PIK3CA alterations 1

Clinical Trial Agents

• Capivasertib and ipatasertib are in Phase III clinical trials for various cancer indications 3
• Other agents in development include MK-2206, perifosine, GSK2141795, and RX-0201 4

Critical Caveats

• AKT inhibitors should only be considered after standard treatment options are exhausted, ideally within clinical trials or well-annotated compassionate use programs 1
• The PI3K/AKT pathway is frequently activated in brain metastases, where PI3K-AKT inhibitors show enhanced anti-tumor activity compared to standard therapies 2
• Molecular profiling is essential before initiating AKT-targeted therapy to identify actionable alterations 1

Please clarify whether you are asking about tuberculosis treatment or cancer therapy targeting the AKT pathway.