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Pilaralisib + trastuzumab is an investigational combination therapy for HER2-positive metastatic breast cancer. Pilaralisib (SAR245408, XL147) is a pan-class I phosphoinositide 3-kinase (PI3K) inhibitor that targets the PI3K/AKT signaling pathway involved in cell growth and survival. Trastuzumab is a monoclonal antibody targeting the human epidermal growth factor receptor 2 (HER2), which is overexpressed in certain breast cancers. The rationale for combining these agents stems from evidence that PI3K pathway activation can mediate resistance to HER2-targeted therapies like trastuzumab. Clinical studies have evaluated this combination in patients with metastatic HER2-positive breast cancer who had progressed on prior trastuzumab-based regimens. The combination has demonstrated an acceptable safety profile and some clinical activity when used with or without paclitaxel[1][4][5].
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