Treating Alpelisib-Induced Hyperglycemia with Very Low Carbohydrate Diets and Sodium-Glucose Co-Transporter 2 Inhibitors: A Case Series

被引：12

作者：

Blow, Tahj ^{[1
]}

Hyde, Parker N. ^{[2
,3
]}

Falcone, John N. ^{[1
]}

Neinstein, Aaron ^{[4
]}

Vasan, Neil ^{[1
,5
]}

Chitkara, Ritika ^{[5
]}

Hurd, Maurice A. ^{[1
]}

Sardesai, Sagar ^{[3
,6
]}

Lustberg, Maryam B. ^{[3
,6
]}

Flory, James H. ^{[5
]}

Volek, Jeff S. ^{[3
]}

Goncalves, Marcus D. ^{[1
]}

机构：

[1] Weill Cornell Med, New York, NY USA

[2] Univ North Georgia, Dahlonega, GA USA

[3] Ohio State Univ, Columbus, OH 43210 USA

[4] Univ Calif San Francisco, San Francisco, CA 94143 USA

[5] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[6] Ohio State Univ, Wexner Med Ctr, Columbus, OH 43210 USA

来源：

INTEGRATIVE CANCER THERAPIES | 2021年 / 20卷

关键词：

PI3K inhibitor; alpelisib; SGLT2; inhibitor; very-low carbohydrate diet; hyperglycemia; PHOSPHATIDYLINOSITOL; 3-KINASE; PLUS FULVESTRANT; BREAST-CANCER;

D O I：

10.1177/15347354211032283

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Alpelisib is a alpha-selective phosphatidylinositol 3-kinase (PI3K) inhibitor approved for treatment of postmenopausal women, and men, with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-), PIK3CA-mutated, advanced breast cancer (ABC). Hyperglycemia is a common, on-target adverse effect that impairs treatment efficacy and increases the rate of treatment delays, dose reductions, and discontinuation. Currently, there are no clear guidelines on how to manage hyperglycemia due to alpelisib when metformin is not effective. In this case series, we review 3 subjects with ABC that developed hyperglycemia during alpelisib-fulvestrant therapy and were successfully managed with dietary and pharmacologic interventions. These cases provide anecdotal evidence to support the use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and very low carbohydrate diets to minimize hyperglycemia during alpelisib therapy.

引用

页数：6

共 14 条

[1] Alpelisib plus fulvestrant for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2enegative advanced breast cancer: final overall survival results from SOLAR-1 [J].

Andre, F. ;

Ciruelos, E. M. ;

Juric, D. ;

Loibl, S. ;

Campone, M. ;

Mayer, I. A. ;

Rubovszky, G. ;

Yamashita, T. ;

Kaufman, B. ;

Lu, Y-S ;

Inoue, K. ;

Papai, Z. ;

Takahashi, M. ;

Ghaznawi, F. ;

Mills, D. ;

Kaper, M. ;

Miller, M. ;

Conte, P. F. ;

Iwata, H. ;

Rugo, H. S. .

ANNALS OF ONCOLOGY, 2021, 32 (02) :208-217

[2] Alpelisib for PIK3CA-Mutated, Hormone Receptor-Positive Advanced Breast Cancer [J].

Andre, Fabrice ;

Ciruelos, Eva ;

Rubovszky, Gabor ;

Campone, Mario ;

Loibl, Sibylle ;

Rugo, Hope S. ;

Iwata, Hiroji ;

Conte, Pierfranco ;

Mayer, Ingrid A. ;

Kaufman, Bella ;

Yamashita, Toshinari ;

Lu, Yen-Shen ;

Inoue, Kenichi ;

Takahashi, Masato ;

Papai, Zsuzsanna ;

Longin, Anne-Sophie ;

Mills, David ;

Wilke, Celine ;

Hirawat, Samit ;

Juric, Dejan .

NEW ENGLAND JOURNAL OF MEDICINE, 2019, 380 (20) :1929-1940

[3] Impact of a 2-year trial of nutritional ketosis on indices of cardiovascular disease risk in patients with type 2 diabetes [J].

Athinarayanan, Shaminie J. ;

Hallberg, Sarah J. ;

McKenzie, Amy L. ;

Lechner, Katharina ;

King, Sarah ;

McCarter, James P. ;

Volek, Jeff S. ;

Phinney, Stephen D. ;

Krauss, Ronald M. .

CARDIOVASCULAR DIABETOLOGY, 2020, 19 (01)

[4] Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial [J].

Athinarayanan, Shaminie J. ;

Adams, Rebecca N. ;

Hallberg, Sarah J. ;

McKenzie, Amy L. ;

Bhanpuri, Nasir H. ;

Campbell, Wayne W. ;

Volek, Jeff S. ;

Phinney, Stephen D. ;

McCarter, James P. .

FRONTIERS IN ENDOCRINOLOGY, 2019, 10

[5] Phase III study of taselisib (GDC-0032) + fulvestrant (FULV) v FULV in patients (pts) with estrogen receptor (ER)-positive, PIK3CA-mutant (MUT), locally advanced or metastatic breast cancer (MBC): Primary analysis from SANDPIPER. [J].

Baselga, Jose ;

Dent, Susan Faye ;

Cortes, Javier ;

Im, Young-Hyuck ;

Dieras, Veronique ;

Harbeck, Nadia ;

Krop, Ian E. ;

Verma, Sunil ;

Wilson, Timothy R. ;

Jin, Huan ;

Wang, Lijia ;

Schimmoller, Frauke ;

Hsu, Jerry Y. ;

He, Jing ;

DeLaurentiis, Michelino ;

Drullinsky, Pamela ;

Jacot, William .

JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (18)

[6] Buparlisib plus fulvestrant in postmenopausal women with hormone-receptor-positive, HER2-negative, advanced breast cancer progressing on or after mTOR inhibition (BELLE-3): a randomised, double-blind, placebo-controlled, phase 3 trial [J].

Di Leo, Angelo ;

Johnston, Stephen ;

Lee, Keun Seok ;

Ciruelos, Eva ;

Lonning, Per E. ;

Janni, Wolfgang ;

O'Regan, Ruth ;

Mouret-Reynier, Marie-Ange ;

Kalev, Dimitar ;

Egle, Daniel ;

Csoszi, Tibor ;

Bordonaro, Roberto ;

Decker, Thomas ;

Tjan-Heijnen, Vivianne C. G. ;

Blau, Sibel ;

Schirone, Alessio ;

Weber, Denis ;

El-Hashimy, Mona ;

Dharan, Bharani ;

Sellami, Dalila ;

Bachelot, Thomas .

LANCET ONCOLOGY, 2018, 19 (01) :87-100

[7] Phosphatidylinositol 3-Kinase, Growth Disorders, and Cancer [J].

Goncalves, Marcus D. ;

Hopkins, Benjamin D. ;

Cantley, Lewis C. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 379 (21) :2052-2062

[8] Suppression of insulin feedback enhances the efficacy of PI3K inhibitors [J].

Hopkins, Benjamin D. ;

Pauli, Chantal ;

Xing, Du ;

Wang, Diana G. ;

Li, Xiang ;

Wu, David ;

Amadiume, Solomon C. ;

Goncalves, Marcus D. ;

Hodakoski, Cindy ;

Lundquist, Mark R. ;

Bareja, Rohan ;

Ma, Yan ;

Harris, Emily M. ;

Sboner, Andrea ;

Beltran, Himisha ;

Rubin, Mark A. ;

Mukherjee, Siddhartha ;

Cantley, Lewis C. .

NATURE, 2018, 560 (7719) :499-+

[9] Beneficial effects of ketogenic diets for cancer patients: a realist review with focus on evidence and confirmation [J].

Klement, Rainer J. .

MEDICAL ONCOLOGY, 2017, 34 (08)

[10]

Mariotto AB, 2017, CANCER EPIDEM BIOMAR, V26, P809, DOI [10.1158/1055-9965.EPI-16-0889, 10.1158/1055-9965.epi-16-0889]

← 1 2 →