Single-center study of incidence, risk factors, and management of alpelisib-associated hyperglycemia in metastatic breast cancer

Addition of the PI3K inhibitor alpelisib to fulvestrant improves progression-free survival of patients with HR-positive, PIK3CA-mutant metastatic breast cancer. A retrospective study at Memorial Sloan Kettering Cancer Center (New York, NY) investigated incidence, risk factors, and treatment of alpelisib-associated hyperglycemia in these patients. The study found that rates of hyperglycemia among real-world patients were significantly higher than among patients in clinical trials. Elevated baseline HbA1c was associated with alpelisib-induced hyperglycemia requiring dose modification. The authors conclude that optimizaion of glycemic status before alpelisib initiation should become routine practice.