Phase 3
Completed N=572
Study Assessing the Efficacy and Safety of Alpelisib Plus Fulvestrant in Men and Postmenopausal Women With Advanced Breast Cancer Which Progressed on or After Aromatase Inhibitor Treatment.
Source: ClinicalTrials.gov NCT02437318 ↗Enrolled (actual)
572
Serious AEs
28.7%
Results posted
Aug 2019
Primary outcomePrimary: Progression-free Survival (PFS) Per Investigator Assessment in the PIK3CA Mutant Cohort — 11.0; 5.7 Months — p=0.00065
◆ Published Evidence
Highly cited
596citations · ~119 / year
Alpelisib plus fulvestrant for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: final overall survival results from SOLAR-1.
Summary
To determine whether treatment with alpelisib plus fulvestrant prolonged progression-free survival (PFS) compared to fulvestrant and placebo in men and postmenopausal women with hormone receptor positive (HR+), human epidermal growth factor receptor-2 (HER2)-negative advanced breast cancer, who received prior treatment with an aromatase Inhibitor (AI) either as (neo)adjuvant or for advanced disease.
Linked Publications (5)
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Alpelisib plus fulvestrant for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: final overall survival results from SOLAR-1.
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Time course and management of key adverse events during the randomized phase III SOLAR-1 study of PI3K inhibitor alpelisib plus fulvestrant in patients with HR-positive advanced breast cancer.
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Patient-Reported Outcomes in Patients With <i>PIK3CA</i>-Mutated Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer From SOLAR-1.
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A risk analysis of alpelisib-induced hyperglycemia in patients with advanced solid tumors and breast cancer.
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SGLT2 inhibition improves PI3Kα inhibitor-induced hyperglycemia: findings from preclinical animal models and from patients in the BYLieve and SOLAR-1 trials.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Progression-free Survival (PFS) Per Investigator Assessment in the PIK3CA Mutant Cohort |
11.0; 5.7 | 0.00065 sig |
| SECONDARY Overall Survival (OS) in the PIK3CA Mutant Cohort |
39.3; 31.4 | — |
| SECONDARY PFS Per Investigator Assessment in the PIK3CA Non-mutant Cohort |
7.43; 7.23 | — |
| SECONDARY OS in the PIK3CA Non-mutant Cohort |
37.29; 34.30 | — |
| SECONDARY Overall Response Rate (ORR) Per Investigator Assessment |
26.6; 13.4; 20.9; 12.9 | — |
| SECONDARY Clinical Benefit Rate (CBR) Per Investigator Assessment |
61.5; 44.8; 53.9; 49.1 | — |
| SECONDARY Time to Definitive Deterioration of Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) Score From Baseline |
34.07; NA; NA; 40.44 | — |
| SECONDARY Time to 10% Deterioration in the Global Health Status (GHS) /Quality of Life (QOL) Scale Score of the European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC QLQ-C30) |
18.14; 19.98; 7.39; 9.23 | — |
| SECONDARY Change From Baseline in the GHS/QOL Scale Score of the EORTC QLQ-C30 |
-2.477; -0.369; 1.524; 2.698; -1.796; -2.685 | — |
| SECONDARY Trough Plasma Concentration of Alpelisib |
424; 468; 436; 458; 418; 469 | — |
| SECONDARY Trough Plasma Concentration of Fulvestrant |
10.8; 10.3; 14.0; 14.7; 11.5; 12.2 | — |
| SECONDARY PFS Per Investigator Criteria in Subjects With PIK3CA Mutation Status Measured in ctDNA at Baseline |
10.9; 3.7; 9.0; 7.4 | — |
Eligibility Criteria
Inclusion Criteria
- If female, the patient was postmenopausal.
- The patient had identified PIK3CA status.
- Patients could be:
- Relapsed with documented evidence of progression while on (neo)adjuvant endocrine therapy or within 12 months from completion of (neo)adjuvant endocrine therapy with no treatment for metastatic disease.
- Relapsed with documented evidence of progression more than 12 months from completion of (neo)adjuvant endocrine therapy and then subsequently progressed with documented evidence of progression while on or after only one line of endocrine therapy for metastatic disease.
- Newly diagnosed with advanced breast cancer, then relapsed with documented evidence of progression while on or after only one line of endocrine therapy.
- The patient had recurrence or progression of the disease during or after AI therapy (i.e., letrozole, anastrozole, exemestane).
- The patient had a histologically and/or cytologically confirmed diagnosis of estrogen-receptor positive breast cancer by a local laboratory and had HER2 negative breast cancer.
- The patient had either measurable disease per RECIST 1.1 criteria or at least one predominantly lytic bone lesion present.
- The patient had adequate bone marrow function.
Exclusion Criteria
- The patient had symptomatic visceral disease or any disease burden that made the patient ineligible for endocrine therapy per the investigator's best judgment.
- The patient had received prior treatment with chemotherapy (except for neoadjuvant/adjuvant chemotherapy), fulvestrant, any PI3K, mTOR, or AKT inhibitor (pre-treatment with CDK4/6 inhibitors was allowed).
- The patient had inflammatory breast cancer at screening.
- Patients had Child pugh score B or C.
- Patients had an established diagnosis of diabetes mellitus type I or uncontrolled type II.
- The patient had Eastern Cooperative Oncology Group (ECOG) performance status 2 or more.
- The patient had CNS involvement unless he/she was at least 4 weeks from prior therapy completion to starting the study treatment and had a stable CNS tumor at the time of screening and was not receiving steroids and/or enzyme-inducing antiepileptic medications for brain metastases.
- The patient had participated in a prior investigational study within 30 days prior to enrollment or within 5 half-lives of the investigational product, whichever was longer.
- The patient had a history of acute pancreatitis within 1 year of screening or a past medical history of chronic pancreatitis.
- The patient relapsed with documented evidence of progression more than 12 months from completion of (neo)adjuvant endocrine therapy with no treatment for metastatic disease.
Data sourced from ClinicalTrials.gov (NCT02437318) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.