The application effect of Alpelisib in advanced breast cancer

In the field of treatment of advanced or metastatic breast cancer, the application value of Alpelisib-Piqray is mainly reflected in its ability to accurately intervene in specific molecular subtypes. Overseas consensus generally believes that Apelvis is not a "broad-spectrum anti-tumor drug", but is specifically targeted at patients with hormone receptor-positive, HER2-negative and PIK3CA mutations. During the endocrine treatment process, this group of people often develop drug resistance due to abnormal activation of the PI3K pathway, making it difficult for traditional endocrine drugs to continuously control disease progression.

PIK3CA mutations cause the PI3Kα enzyme to remain activated, thereby transmitting growth-promoting signals downstream, allowing cancer cells to gain the ability to "bypass endocrine blockade." By selectively inhibiting this abnormal enzyme activity, Apelix weakens the growth-driving signals of tumor cells from the source. This mechanism of action allows the tumor to regain its sensitivity to endocrine intervention after endocrine therapy fails. Therefore, in overseas clinical pathways, apelvis is often regarded as “the key supplementary regimen after endocrine resistance.”

Judging from the overall evaluation of the application effect, the international academic community is more inclined to use "improvement in disease control capabilities" to describe the clinical significance of Apelvis, rather than simply emphasizing short-term tumor reduction. For such patients with clear molecular characteristics, the value of combination therapy lies in delaying disease progression, delaying entry into more toxic treatment stages, and at the same time providing patients with a more stable quality of life. This treatment goal is highly consistent with the concept of "long-term management of chronic tumors" in the era of precision medicine.

In addition, the application of Apelvis has also promoted the standardization of testing strategies. Before considering using this drug, the PIK3CA mutation status must be confirmed through approved testing methods. This not only helps to improve the success rate of treatment, but also avoids the risk of ineffective drug use. It can be said that the clinical effect of Apelvis is not only reflected in the drug itself, but also in the precise stratified treatment model it promotes.

Reference materials:https://www.piqray.com/