Alisertib with Fulvestrant

Hey Anne,

I've read about Alisertib on here also and am super interested in it. I believe ann1999 has been on it for a while.

Good luck and hope you have a run on it!

Ann

Hi all! I’ve been on this trial for seven months. Very tolerable drug for me. SE included hair loss, fatigue, neutropenia. Was initially randomized to Alisertib alone but just had progression so added Faslodex. Getting six months or so of stable disease was huge for me as no other treatments worked at all. Mayo Rochester was the only site initially that had the trial from what I know but within the last month or two several other sites opened so thinking they are seeing good results!!

Best to all

Cure-ious- thanks for sharing the link. Very interesting about the role of statins. Keeping my fingers crossed the dual therapy works.

Anne45 - Hoping great success for you on the trial. Are you on the 3 days/week for three weeks with the fourth week off pill schedule - with the Fulvestrant shots?

Hi Anne- the second time I had low neutrophils the dose was decreased to 40mgs. I was told the trial allows for neulasta or neupogen which helps to keep the counts up so you wont be kicked off the trial. I was told can only be low 2x. So it’s almost guaranteed I will get neulasta - unless progression kicks me off first. I have had two shots of the fulvestrant and have noticed more fatigue and nausea but keepin going.

Not sure which one would be better or if one is better than the other. I had neulasta in 2013 and it worked very well with no SE for me however I’ve read on the boards many have had a lot of bone pain but not sure which drug they had. I didn’t get a choice back then.

Hi all, This is my first post.

I have been reading and following several threads ever since my mom progressed on Ibrance / Faslodex in Feb. She then had a liquid biopsy sent to Foundation One with ESR1 and PIK3ca markers

I am so thankful for everyone who posts about their experiences and especially the research posts and links from Cure-ious. Based on this research we are looking into 2 trials:

Alisertib clinicicaltrial: NCT02860000 or Alpelisib: clinical trial NCT03056755

We are soliciting a 2nd opinion and are hoping to make a decision very soon. Alpelisib seems like it may have more potential SE than Alisertib? Definitely interested in hearing what others would recommend or other's experience.

thanks!

Andrea

Hello everyone, we(my fiancé) are starting alisertib trial in 10 days time. Hoping for the best.

Welcome Bornfighter

Bornfighter, I'm so very sorry that your fiancé is no longer eligible for the Alisertib trial! I was turned down for both of the Alpelisib trials (Solar1 and ByLieve), but may still have access to Alpelsib when it's approved later this year. Hopefully the Alisertib trial will be positive and it will become available outside of trials. In the meantime, I'll be praying that the platinum-based chemo will be very effective against her cancer. She is very fortunate to have you as her advocate! Very best wishes! Theresa

I’m in my first cycle for this trial; getting the alisertib/fluvestrent combo. The first week was rough with a lot of digestion problems and a wee bit of nausea. SE have mellowed quite a bit, but my hair has started falling out. My first blood work was today, not sure about my counts yet. Ibrance/letrozole worked for about a year on me. Hoping thus will have a long run as well. Glad I found this thread. It’s hard to find any practical info about alisertib.

FYI I went through initial bc treatment in 2012 with taxotere and cytoxin, radiation, lumpectomy. The usual.

Hi Cure-ious. Thanks for the well wishes. I was surprised how quickly it fell out too and that it was so much, but maybe it means it is working. First year of mbc diagnosis I was on iBrance, zoladex, and letrozol. (Sorry about misspelling meds, there’s only so much I can retain.) I never tolerated iBrance. My neutrophils were always low. Ibrance cleared up mets in the lungs and slowed down the liver. Once it stopped working I was on ibrance and faslodex for about three months. That didn’t work at all. Moved my care to MD Anderson and they put me on this phase II trial of alisertib. I was randomized to the arm with faslodex. To qualify for the trial I had to get an oophorectomy. I’ve had a lot of testing done on the liver mets. So far nothing unusual, just very aggressive. My MO is looking at HER3.

M3,

Aurora A kinase, like a PI3K mutation, turns on the PI3K/mTORC1 pathway. So, if you respond to Alisertib (and Aurora A kinase inhibitor), the cancer likely has high PI3K kinase activity.

If so, it would help to add in an NSAID. This idea came from a study of head and neck cancers, where they showed that people who have PI3K mutant cancers (therefore high PI3K kinase activity) had a much higher five-year disease-free survival if they took daily NSAIDs (72%) than those who did not (25%). So the recommendation came out that people with cancers of any type that have PI3K mutations or high PI3K activity should be treated with some kind of aspirin/ibuprofen/Celebrex.

The PI3K mutation causes the cells to increase prostaglandin and inflammation, and the NSAIDs counteract that- plus they help the immune response. The question is how much- would a baby aspirin do it? Or you need the higher levels of Ibuprofen that they use to reduce swelling and inflammation. If it hasn't already come up, its something worth discussing with your onc...