PIK3CA hotspot mutations (~40% of HR+/HER2- metastatic breast cancer): alpelisib + fulves...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-PIK3CA-EXON20-BREAST |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-BREAST |
| Sources | SRC-CIVIC SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Actionability Facts
| Biomarker | BIO-PIK3CA-MUTATION |
|---|---|
| Variant | exon 20 (kinase domain) any pathogenic |
| Disease | DIS-BREAST |
| ESCAT tier | IA |
| Recommended combinations | alpelisib + fulvestrant, inavolisib + palbociclib + fulvestrant, capivasertib + fulvestrant |
| Evidence summary | PIK3CA hotspot mutations (~40% of HR+/HER2- metastatic breast cancer): alpelisib + fulvestrant improves PFS vs fulvestrant alone (SOLAR-1, André et al. NEJM 2019) in PIK3CA-mut after AI failure. Inavolisib + palbociclib + fulvestrant (INAVO120, Turner et al. NEJM 2024) improves PFS in 1L PIK3CA-mut HR+/HER2- with ET-resistance — FDA-approved 2024. Capivasertib + fulvestrant (CAPItello-291, Turner et al. NEJM 2023) also active in PIK3CA-mut. |
Notes
ESCAT IA. Catch-all for non-canonical exon 20 PIK3CA hotspots.
Used By
No reverse references found in the YAML corpus.