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**SNV4818 + fulvestrant** is an investigational, orally administered combination therapy comprising SNV-4818, a pan-mutant-selective small molecule inhibitor of Phosphoinositide 3-kinase alpha (PI3Kα), and fulvestrant, an established selective estrogen receptor degrader (SERD). SNV-4818 is developed to selectively inhibit mutant PI3Kα (not wild-type), targeting kinase (H1047X) and helical domain (E545/E542X) mutations frequently found in advanced solid tumors, especially hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) breast cancer. Fulvestrant acts by promoting degradation of the estrogen receptor, thus blocking estrogen-driven tumor growth. The combination is under investigation specifically to overcome endocrine resistance mediated by PI3K pathway activation, aiming to improve efficacy and reduce toxicities common with earlier PI3Kα inhibitors[1][2][3].
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