Alpelisib 是一种 PI3K（磷酸肌醇 3-激酶）抑制剂，用于治疗乳腺癌，由于其对葡萄糖代谢调节的作用而导致高血糖。本研究旨在确定预测高血糖发生的潜在危险因素以及接受 Alpelisib 治疗的患者是否需要对高血糖进行多种治疗。通过肿瘤科会诊对 14 名被诊断患有携带 PI3K 突变的转移性激素受体阳性乳腺癌且开始接受 Alpelisib 治疗的女性进行监测和内分泌科。生成非参数 ROC 曲线来评估是否需要三种或更多抗糖尿病药物来实现血糖控制。研究人群的中位年龄为 64 岁（范围：48-69），中位体重指数 (BMI) 为 26.6千克/平方米（范围：22.9-29.4）。 35.7% 的参与者超重，21.4% 的参与者肥胖。 50% 的参与者患有糖尿病前期，85.7% 的参与者出现高血糖，需要药物治疗，但没有人因此需要停止治疗。基线 C 肽水平和 BMI 与所用抗糖尿病药物的数量相关（分别为 Spearman's Rho 0.553，p = 0.040；Spearman's Rho 0.581，p = 0.030）。 ROC 曲线分析显示，可变风险状况（定义为基线 C 肽 >10.5ng/ml 和 BMI>27kg/m2）的曲线下面积 (AUC) 为 0.819，而 HbA1c 和 HbA1c 的 AUC 值为 0.556 和 0.514。基线血糖分别为 (p = 0.012)。肿瘤科和糖尿病科的联合随访可以防止接受 Alpelisib 治疗的患者停止治疗。基线 BMI 和血浆 C 肽水平可以预测抗高血糖治疗需求的增加。© 2024。作者。

Alpelisib is a PI3K (Phosphoinositide 3-kinases) inhibitor used for breast cancer which develops hyperglycemia based on its action on glucose metabolism regulation. This study aims to identify potential risk factors predicting hyperglycemia development and the need for multiple treatments for hyperglycemia in patients receiving Alpelisib.Fourteen women diagnosed with metastatic hormone receptor-positive breast cancer carrying PI3K mutations who initiated treatment with Alpelisib were monitored through consultations in the Oncology and Endocrinology departments. Non-parametric ROC curves were generated to assess the need for three or more antidiabetic medications to achieve glycemic control.The study population had a median age of 64 years (range:48-69) with a median body mass index (BMI) of 26.6 kg/m2 (range: 22.9-29.4). Overweight was observed in 35.7% of the participants and obesity in 21.4%. Fifty percent of the participants had prediabetes, and 85.7% developed hyperglycemia requiring pharmacological treatment, although none of them needed to discontinue treatment for this reason. Baseline C-peptide levels and BMI were associated with the number of antidiabetic drugs used (Spearman's Rho 0.553, p = 0.040; Spearman's Rho 0.581, p = 0.030, respectively). ROC curve analysis showed and area under the curve (AUC) of 0.819 for the variable risk profile (defined as baseline C-peptide >10.5 ng/ml and BMI > 27 kg/m2), whereas AUC values were 0.556 and 0.514 for HbA1c and baseline glucose, respectively, (p = 0.012).A joint follow-up by an Oncology department and a Diabetes Unit can prevent treatment discontinuation in patients under Alpelisib therapy. Baseline BMI and plasma C-peptide levels can predict an increased need for anti-hyperglycemic treatment.© 2024. The Author(s).