What disease characteristics will guide your choice of alpelisib plus fulvestrant (per SOLAR-1) versus capivasertib plus fulvestrant (per CAPItello-291) in PIK3CA mutated advanced ER+/HER2- breast cancer after progression on 1L ET regimen, given both are now approved in this population?

In the absence of head-to-head comparison, I would use cross-trial comparison to compare the efficacy and safety of alpelisib vs capivasertib. mPFS are similar for both: HR 0.65 (11 vs 5.7 months) for alpelisib (SOLAR-1); and mPFS HR 0.6 (7.2 vs 3.6 months) for capivasertib (CAPItello-291). Therefor...

This is a great question.

Eligibility criteria for the two trials were similar, except for added tumor mutation allowing capivasertib. Both trials included patients with PIK3CA muatation.

For SOLAR-1: Eligible patients included men and postmenopausal women who had locally confirmed HR-positive, HER...

In deciding between alpelisib and capivasertib in PIK3CA mutated HR+ advanced breast cancer, I am considering less tumor-related factors and more patient-related factors. I see these medications as being unique mostly from a tolerability/safety standpoint. Alpelisib is associated with more hyperglyc...