Genomic Determinants of Response to Alpelisib Plus Fulvestrant in the SOLAR-1 Trial - PubMed
5 hours ago
- #Breast Cancer
- #Alpelisib
- #Genomic Determinants
- Alpelisib combined with fulvestrant significantly improves median progression-free survival (11.01 months) compared to placebo plus fulvestrant (5.55 months) in PIK3CA-altered HR+/HER2- advanced breast cancer.
- Patients with low tumor mutational burden or FGFR1/FGFR2 alterations derive greater PFS benefit from alpelisib plus fulvestrant, while those with MYC or RAD21 alterations see limited benefit.
- Cox and machine learning models identified poorer ECOG performance status, prior CDK4/6i treatment, and PTEN or TP53 alterations as negative prognostic factors for PFS in PIK3CA-altered patients.
- Genomic profiles differ between PIK3CA-altered and PIK3CA-wild type tumors, with alpelisib showing efficacy across various concomitant alterations, including those linked to therapy resistance.
- The study supports alpelisib plus fulvestrant as beneficial for PIK3CA-altered advanced breast cancer, with genomic factors influencing treatment response identified through NGS and machine learning.