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**OKI-219 + fulvestrant** is an investigational combination therapy under clinical evaluation for hormone receptor-positive (HR+), HER2-negative, locally advanced, unresectable, or metastatic breast cancer harboring the PI3Kα H1047R mutation. OKI-219 is a small molecule, highly selective, mutant-specific inhibitor of PI3K alpha (phosphoinositide 3-kinase catalytic subunit alpha) targeting the H1047R mutation, developed to overcome resistance and enhance efficacy of endocrine therapies. Fulvestrant is a selective estrogen receptor degrader (SERD) that antagonizes and degrades the estrogen receptor. In combination, OKI-219 inhibits oncogenic PI3K signaling in mutant tumor cells, while fulvestrant blocks estrogen receptor-dependent proliferation, aiming for synergistic antitumor effects.
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