Evidence map›Paper›PMID 40152314›Full record

ArticleThe oncologist2025

Dynamics of hyperglycemia of patients treated with alpelisib: exploratory interim analysis of ITACA trial.

Marija Pancirov, Josipa Flam, Jelena Šuto Pavičić, Dora Čerina Pavlinović, Natalija Dedić Plavetić, Paula Podolski, Žarko Bajić, Mladen Krnić, Eduard Vrdoljak

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Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Marija PancirovDepartment of Oncology, University Hospital Center Split, School of Medicine, University of Split, 21 000 Split, Croatia.
Josipa FlamDepartment of Radiotherapy and Oncology, University Hospital Center Osijek, School of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
Jelena Šuto PavičićDepartment of Oncology, University Hospital Center Split, School of Medicine, University of Split, 21 000 Split, Croatia.
Dora Čerina PavlinovićDepartment of Oncology, University Hospital Center Split, School of Medicine, University of Split, 21 000 Split, Croatia.
Natalija Dedić PlavetićDepartment of Oncology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia.
Paula PodolskiDepartment of Oncology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia.
Žarko BajićResearch Unit "Dr. Mirko Grmek" Psychiatric Clinic Sveti Ivan, 10 000 Zagreb, Croatia.
Mladen KrnićDepartment of Endocrinology, University Hospital Center Split, School of Medicine, University of Split, 21 000 Split, Croatia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlpelisib and fulvestrant combination has improved outcomes in patients with phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)-mutated, hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2-)- advanced breast cancer (BC) who relapsed or progressed on prior endocrine therapy. Hyperglycemia, on target toxicity, is a frequent adverse event occurring in over 60% of patients.

objectivesThe ITACA trial explores whether low carbohydrate dietary modifications and evening dosing of alpelisib to potentially mitigate impact of food on hyperglycemia. This exploratory interim analysis aimed to quantify the incidence and timing of hyperglycemia in the ITACA trial's pooled sample.

methodsThis exploratory interim analysis of the ongoing ITACA trial included 23 patients with HR+, HER2-negative metastatic BC receiving alpelisib and fulvestrant. The exploratory outcomes were grade 2-4 hyperglycemia-free survival and time to onset of hyperglycemia.

resultsMost patients, 21 (91.3%), experienced any-grade hyperglycemia (Grade 1: 9 [39.1%], Grade 2: 8 [34.8%], Grade 3: 4 [17.4%], and Grade 4: 0 [0.0%]) within the first week of alpelisib initiation. The median grade 2-4 hyperglycemia-free survival was 6 days (95% CI 3; 44 days).

conclusionsThis exploratory interim analysis demonstrated the rapid onset of hyperglycemia in patients receiving alpelisib, even with the ITACA trial's dietary interventions. Proactive monitoring, within the first week after initiation of treatment, and early management of hyperglycemia are crucial in this patient population.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsHyperglycemiaAdultAgedFemaleFulvestrantHumansMiddle AgedThiazolesAlpelisibFulvestrantThiazolesalpelisibbreast cancerdietglucosehyperglycemiaPIK3CA mutation

Identifiers

PMID40152314
PMCPMC11950915

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