Drug intelligence / Profile preview

fulvestrant + abemaciclib + copanlisib

Development stage
Unknown
Lead developer
Washington University School of Medicine
Modality
Small Molecules
Administration
Intramuscular, Oral, Intravenous
01

Overview

Fulvestrant + Abemaciclib + Copanlisib (FAC) is an investigational triplet combination therapy developed by Washington University School of Medicine for the treatment of hormone receptor-positive (HR+), HER2-negative metastatic breast cancer that has become resistant to endocrine therapy. The regimen consists of three small molecule targeted agents: fulvestrant, a selective estrogen receptor degrader (SERD) administered intramuscularly; abemaciclib, an oral CDK4/6 inhibitor; and copanlisib, an intravenous PI3K inhibitor with activity against α and δ isoforms. The rationale for this combination is that simultaneously blocking the estrogen receptor, CDK4/6, and PI3K pathways may overcome resistance mechanisms and provide greater efficacy than targeting these pathways individually. A Phase I clinical trial (NCT03939897) evaluated the safety and recommended Phase II dose, but the Phase II portion was removed in late 2023 following Bayer's voluntary withdrawal of the copanlisib NDA.

Brand names
Verzenio (abemaciclib)Aliqopa (copanlisib)Faslodex (fulvestrant)
Other names
Fulvestrant + Abemaciclib + Copanlisib
02

Targets

PIK3CG (Phosphatidylinositol 4,5-bisphosphate 3-kinase gamma)CDK4 (Cyclin-dependent kinase 4)PIK3CB (Phosphatidylinositol 3-kinase beta subunit)ESR1 (ERα)PIK3CA (Phosphoinositide 3-kinase alpha)PIK3CD (Phosphatidylinositol 3-kinase delta)CDK6 (Cyclin-dependent kinase 6)HIPK3DYRK1A (Dual-specificity tyrosine-phosphorylation-regulated kinase 1A)

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