PI3 Kinase Inhibitors for Metastatic Breast Cancer
What are PI3 kinase inhibitors?
PI3 kinase is an enzyme important in cell growth. The PIK3CA gene helps control PI3 kinase enzyme activity.
Some breast cancers have a PIK3CA gene mutation. This mutation is in the genes of the breast cancer, not the genes of the person. The tumor is checked to find out if the cancer cells have a PIK3CA mutation.
PI3 kinase inhibitors are drugs designed to interrupt PI3 kinase signals and stop the growth of breast cancer cells with PIK3CA gene mutations.
Alpelisib (Piqray) is a PI3 kinase inhibitor. Alpelisib is used in combination with hormone therapy to treat some hormone receptor-positive metastatic breast cancers.
Alpelisib (Piqray) and metastatic breast cancer treatment
Alpelisib in combination with the hormone therapy fulvestrant is FDA-approved to treat hormone receptor-positive, HER2-negative metastatic breast cancers with a PIK3CA gene mutation that have been treated with hormone therapy in the past.
The combination of alpelisib and fulvestrant can give more time before the cancer spreads compared to fulvestrant alone .
If alpelisib is being considered for your treatment plan, your tumor will be checked to see if the cancer cells have a PIK3CA gene mutation. This can be done by testing tumor tissue or testing for tumor DNA in your blood .
Learn more about treatment for metastatic breast cancer.
How is alpelisib given?
Alpelisib is a pill.
Side effects of alpelisib
Possible side effects include high blood sugar, diarrhea, nausea, decreased appetite, rash, vomiting, fatigue and hair loss.
Blood sugar levels are monitored while taking alpelisib because nearly everyone who takes it gets high blood sugar levels.
It’s recommended you take an antihistamine, such as cetirizine (Zyrtec), to lower the risk of rash.
Adapted from select sources [20-21].
Monitoring metastatic breast cancer
You’ll be monitored (checked) regularly with scans to see if the cancer is responding to treatment. If it’s no longer working, or if the side effects are not manageable, your health care provider will change your treatment.
Learn more about how metastatic breast cancer is monitored.
Clinical trials offer the chance to try new treatments and possibly benefit from them.
Consider joining a clinical trial when your oncologist is considering changing treatments, before starting a new treatment or when there are limited treatment options.
Susan G. Komen® Breast Care Helpline
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Metastatic Trial Search
The Metastatic Trial Search is a web-based clinical trial matching tool that can help you find clinical trials that fit your needs.
Learn more about clinical trials for people with metastatic breast cancer.
Prescription drug assistance
The cost of drug therapies for metastatic breast cancer can quickly become a financial burden for you and your family.
Medicare and many insurance companies offer prescription drug plans. One may already be included in your policy, or you may be able to buy an extra plan for prescriptions.
Some drugs are off-patent and may have a generic form. Generic drugs cost less than the name brands but are just as effective.
You may also qualify for programs that help with drug costs or offer low-cost or free prescriptions.
Learn more about other financial assistance programs.
Komen Financial Assistance Program
Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals.
Funding is available for eligible individuals undergoing breast cancer treatment at any stage or living with metastatic breast cancer (stage IV).
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Susan G. Komen®‘s position on fairness in oral cancer drug coverage
Insurance coverage of oral cancer drugs
Cancer medications given by vein (through an IV) or injection (under the skin or into a muscle) are usually covered under a health insurance plan’s medical benefit. However, cancer medications that are pills (oral cancer drugs) are usually covered under a health insurance plan’s prescription drug benefit.
As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral cancer drugs. Sometimes these costs can be thousands of dollars a month.
The impact of high cost-sharing
High prescription drug costs and the resulting out-of-pocket burden on patients are a barrier to care. They can prevent people from getting the medications prescribed by their health care providers.
No one should be forced to get less appropriate treatment because an insurer gives more coverage for IV and injectable drugs than pills.
Efforts to increase fairness in drug coverage
Komen supports state and federal efforts to require insurers to provide the same or better coverage for oral cancer drugs as they do for IV and injectable cancer drugs. This would help make sure patients have access to affordable, appropriate treatment.
Become a Komen Advocacy Insider
Sign up to be a Komen Advocacy Insider and get informed when action is needed on drug coverage issues at the state or national level.
SUSAN G. KOMEN® SUPPORT RESOURCES
Read our perspective on metastatic breast cancer.*
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.
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