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**Zovegalisib + fulvestrant** is an investigational combination regimen consisting of zovegalisib (RLY-2608), an oral, mutant-selective, allosteric inhibitor of phosphatidylinositol 3-kinase alpha (PI3Kα), and fulvestrant, an intramuscular selective estrogen receptor degrader (SERD). Developed by Relay Therapeutics, this combination is designed to treat patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer harboring PIK3CA mutations. By combining mutant-selective PI3Kα inhibition with estrogen receptor degradation, the regimen aims to overcome endocrine therapy resistance while minimizing the off-target toxicities (such as hyperglycemia and diarrhea) typically associated with non-selective, orthosteric PI3K inhibitors. The combination has received FDA Breakthrough Therapy designation and is being evaluated in the Phase 3 ReDiscover-2 trial.
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