Breast Cancer Drug May Trigger High Blood Sugar

For certain patients with advanced breast cancer, a drug called Piqray may extend survival. But new research confirms the medication often causes seriously high blood sugar levels.

Taken as a pill, Piqray is a kinase inhibitor that blocks the signals that cause cancer cells to multiply. It is used along with Faslodex , a hormone therapy, to combat tumors that express the PIK3CA mutation and are hormone receptor-positive and HER2-negative.High blood sugar, or glucose, levels occur when the body has too little insulin or can't use insulin properly, and it sets the stage for diabetes.

Most people developed high blood sugar within 16 days of starting the medication, the study showed. The risk was higher among those who had elevated hemoglobin A1c before starting the drug. Among those who developed high blood sugar, two-thirds received treatment, most commonly with the diabetes drug metformin.

Alpelisib is the only U.S. Food and Drug Administration-approved PI3K inhibitor. "There are several newer mutation-specific PI3K inhibitors that are currently in clinical trials which do not cause hyperglycemia, but it is unknown whether they are as effective,” Iyengar said. This doesn’t stop her from prescribing the drug, however. “It works well for a specific group of patients, and it is an oral medication taken at home,” she said.

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