Key clinical point: Alpelisib, selective for the alpha isoforms of the phosphatidylinositol 3-kinase, appears to have better tolerability than, and similar efficacy to, pan–phosphoinositide 3-kinase inhibitors.
Major finding: Median progression-free survival was 11 months with alpelisib/fulvestrant in patients with PIK3CA mutations, compared with 5.7 months for placebo/fulvestrant.
Study details: A randomized, phase 3 trial in 572 patients with hormone receptor–positive, HER2-negative advanced breast cancer.
Disclosures: SOLAR-1 was sponsored by Novartis. Dr. André disclosed research grants from Novartis and others; Dr. Dent disclosed advisory board, honoraria, or travel support from Novartis and others; Dr. Harbeck disclosed honoraria for consulting and lecturing for Pfizer and others.
Andre F et al. ESMO 2018, Abstract LBA3_PR.
This Week's Must Reads
Vanderbilt staging best for predicting overall survival in retroperitoneal sarcoma, Huggett B & Cates J. Modern Pathology; 5 Nov. 2018. https://www.nature.com/articles/s41379-018-0166-8
Older patients with ccRCC may respond better to treatment than younger patients, Feulner et al. Urol Oncol. 2018 Nov 23. doi: 10.1016/j.urolonc.2018.11.006.
SRS can effectively control brain metastases in patients with RCC, Wardak Z et al. Clin Genitourin Cancer. 2018 Nov 20. doi: 10.1016/j.clgc.2018.11.006.
Still no validated biomarkers to select RCC treatment, D’Avella C et al. Urol Oncol. 2018 Nov 23. doi: 10.1016/j.urolonc.2018.10.027
DSS of ccRCC patients lower with high hTERT, Zanjani LS et al. Pathology. 2018 Nov 19. doi: 10.1016/j.pathol.2018.08.019.
Must Reads in Breast Cancer
Advanced age not linked with risk from nipple-sparing mastectomy, Cox S et al. and Bartholomew AJ et al. Session SF310 ACS Clinical Congress 2018
Avoiding topical agents prior to RT may be unnecessary, Baumann BC et al. JAMA Oncol. 2018 Oct 18. doi: 10.1001/jamaoncol.2018.4292
Men with MBC have a similar prognosis compared with women, Sirieix et al. ESMO 2018, Abstract 294PD; Reinisch et al. ESMO 2018, Abstract 273PD
Targeted therapy with PI3K inhibitor boosts PFS in advanced breast cancer, Andre F et al. ESMO 2018, Abstract LBA3_PR.
Inherited mutations account for 12% of Nigerian breast cancer, Olopade et al. J Clin Oncol. 2018 Aug 21. doi: 10.1200/JCO.2018.78.3977.