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Topics:
Breast Cancer • Medical Oncology
Would you risk offering alpelisib or everolimus to a patient with metastatic ER+ HER2- breast CA with Type 1 DM?
PIK3CA and ESR1 mutations on NGS without other targets and who has progressed on CDK 4/6 & AI and several single agent chemotherapies. Aside from support from an endocrinologist, what additional precautions would you take?
Answer from: Medical Oncologist at Academic Institution
In the randomized phase 3 study with alpelisib (Andre, 2019 NEJM) patient with type 1 diabetes or uncontrolled type 2 diabetes were excluded. Nonetheless, the most frequent adverse events of grade 3 or 4 were hyperglycemia (36.6% in the alpelisib–fulvestrant group). Given lack of data and high...
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