English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Alpelisib is a new targeted anticancer drug approved for the treatment of certain types of cancers, including advanced breast cancer. Mifepristone is a progesterone receptor antagonist that has generated renewed interest in its use as an anticancer agent. Some studies find the risk of hypokalemia to be 18% when treating with alpelisib. In higher dosages, mifepristone also blocks the glucocorticoid receptor but not the mineralocorticoid receptor. Thus, it has been approved for treatment of hyperglycemia related to Cushing’s syndrome. However, the higher dosages needed for Cushing’s syndrome can cause hypokalemia related to excessive mineralocorticoid effect. This case of advanced breast cancer did not exhibit hypokalemia when treated with single agent alpelisib. When mifepristone was added, hypokalemia ensued along with very high serum cortisol levels. Discontinuing the mifepristone and treating with single agent alpelisib, resulted in normal potassium levels. Furthermore, the elevated cortisol levels returned to normal. Stopping alpelisib and switching to single agent mifepristone also resulted in normokalaemia and normal cortisol levels. These data suggest that alpelisib interferes with metabolism or clearance of mifepristone. A treating physician must be cautious about using these two drugs together. If treatment with both is intended, a dose reduction should be considered. *Correspondence: Jerome H. Check, M.D., Ph.D., Cooper Medical School of Rowan University, 7447 Old York Road, Melrose Park, PA 19027, U.S.A. Tel: +1 215-635-4156, Fax: +1 215-635-2304. Received: 25 October 2020; Accepted: 14 November 2020

cancer science and research

Alpelisib Combined with Low Dose Mifepristone for Treating Advanced Breast Cancer May Cause Hypokalemia Even When This Complication Does Not Occur from Single Use of The Anticancer Agents