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?
Community PollStarted
Would you treat a patient with metastatic ER+ HER2- breast CA with type 1 DM with alpelisib after progression on CDK 4/6 & AI and several single agent chemotherapies?
49 physicians have voted
Join Mednetto vote and see how they answered.
1 Answer
Mednet MemberInvited Expert
Medical Oncology · Yale
Answered on · Updated on
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 incid...
Join for free or sign in to see the full answer