Alpelisib-Induced Diabetic Ketoacidosis.
Paul Nguyen1, Aya Musa2, Julie Samantray3,2
1Internal Medicine, Wayne State University School of Medicine, Detroit, USA.
Cureus
|June 4, 2021
Summary
Alpelisib, a breast cancer drug, can cause diabetic ketoacidosis. Patients need careful monitoring of blood glucose and HbA1C levels due to this rare but serious side effect.
Area of Science:
- Oncology
- Pharmacology
- Endocrinology
Background:
- Alpelisib is an FDA-approved antineoplastic agent targeting PI3K for PIK3CA-mutated breast cancer.
- PIK3CA mutations are common in HR+/HER2- advanced breast cancer, indicating poor prognosis.
Observation:
- This report details the third case of alpelisib-induced diabetic ketoacidosis.
- Diabetic ketoacidosis is a rare side effect (0.7%) compared to common toxicities like diarrhea and rash.
Findings:
- Alpelisib inhibits the PI3K pathway, crucial for cell processes, leading to antitumor activity.
- Common side effects include diarrhea, rash, nausea, fatigue, and decreased appetite.
Implications:
- Increased use of alpelisib necessitates vigilant screening and monitoring for diabetic ketoacidosis.
- Fasting plasma glucose, HbA1C, and ongoing monitoring are crucial for patient safety during alpelisib treatment.
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