Vevorisertib trihydrochloride (ARQ 751 trihydrochloride) is a selective and potent inhibitor of pan-AKT and AKT1-E17K mutations, inhibiting AKT1, AKT2 and AKT3. Vevorisertib trihydrochloride is used in the study of hepatocellular carcinoma and advanced solid tumours.

Vevorisertib trihydrochloride at concentrations ranging from 0 to 1000 nM over 2 hours inhibits the phosphorylation of AKT1-E17K. In NIH 3T3 cells transfected with pcDNAAKT-WT-GFP or pcDNA-E17K-GFP and treated with 1 μM of the compound for the same duration, it prevents the plasma membrane translocation of both AKT-WT and AKT1-E17K, regardless of growth factor presence. Additionally, a 5 μM concentration results in 57% inhibition of full-length AKT1. The compound demonstrates a dose-dependent impact on mTORC1 and AKT substrates, such as PRAS40, GSK3β, FOXO, BAD, and AS160 across various cancer cell lines with distinct concentrations (0 to 1 μM, 2 hours). It also exhibits significant anti-proliferative effects on esophageal, breast, and head and neck cancer cells, with GI 50 values below 1 μM, and showcases potent efficacy in PIK3CA mutant cell lines. Moreover, a combination of Vevorisertib trihydrochloride (MK-4440) and imatinib mesylate leads to cell cycle arrest and increased cell death in gastrointestinal stromal tumor cells. Western Blot analyses reveal the compound's effectiveness in inhibiting phosphorylation of AKT1-E17K and dose-dependent effects on mTORC1 and AKT substrates across different cell lines, including those with PIK3CA mutations and various cancer-related mutations.

Vevorisertib trihydrochloride administered orally at doses of 25, 50, and 75 mg/kg for five consecutive days followed by a four-day break over a 20-day period demonstrated significant tumor growth inhibition rates of 68%, 78%, and 98%, respectively, in endometrial PDX mouse xenograft models featuring the AKT1-E17K mutation. When administered daily at varying doses (5, 10, 20, 40, 80, and 120 mg/kg) for ten days in AN3CA mouse xenograft models, it showed tumor growth inhibition rates ranging from 29% to 92%. The compound achieved C max plasma concentrations of ≥2 μM and was generally well-tolerated at all administered doses up to 120 mg/kg. Additionally, a combination of Vevorisertib trihydrochloride (MK-4440) and IM exhibited superior efficacy in an IM-sensitive preclinical GIST model compared to either agent alone, highlighting its potential as a robust therapeutic candidate in specific cancer models.