Bang YJ, et al. - In patients with locally advanced or metastatic gastric/gastroesophageal junction cancer (GC/GEJC) not amenable to curative therapy, researchers assessed outcomes after random administration 1:1 of ipatasertib or placebo, plus mFOLFOX6 (modified regimen of leucovorin, bolus and infusional 5-fluorouracil [5-FU], and oxaliplatin) in this randomised, double-blind, placebo-controlled, multicentre, phase II trial. They reported a median progression-free survival (PFS) (intent-to-treat) of 6.6 months vs 7.5 months with ipatasertib/mFOLFOX6 vs with placebo/mFOLFOX6, respectively, among 153 enrolled patients. They noted that in biomarker-selected patient subgroups [PTEN (phosphatase and tensin homolog)-low and PI3K/Akt pathway–activated tumours), there was no statistically significant PFS benefit with ipatasertib/mFOLFOX6 vs placebo/mFOLFOX6. In the ipatasertib arm, they observed higher rates of AEs leading to treatment withdrawal and serious AEs. Overall, in unselected or biomarker-selected patients, no improved PFS was offered by ipatasertib/mFOLFOX6 vs placebo/mFOLFOX6. No unexpected safety concerns were observed.