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Breast Cancer — SCE Medical Oncology MCQ

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HardBreast CancerBreast CancerSCE Medical Oncology

A postmenopausal patient with PIK3CA-mutated HR-positive/HER2-negative metastatic breast cancer progresses on first-line palbociclib plus letrozole. She has no visceral crisis and remains suitable for endocrine-based therapy. Which targeted endocrine regimen matches NICE TA816?

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Correct answer: E — Alpelisib plus fulvestrant

NICE TA816 specifically recommends alpelisib with fulvestrant after progression on a CDK4/6 inhibitor plus an aromatase inhibitor in PIK3CA-mutated HR-positive/HER2-negative advanced disease. The alternative partner combinations do not reproduce the appraisal population and regimen.

Reference: NICE TA816: alpelisib with fulvestrant. https://www.nice.org.uk/guidance/TA816/chapter/1-Recommendations