PIK3CA and neoplasm: Alpelisib given in combination with fulvestrant resulted in a significant progression-free survival benefit compared with fulvestrant alone, although only in participants with PIK3CA-mutant tumours, and it has not shown significantly prolonged overall survival compared with fulvestrant alone.12, 13 The addition of the mTORC1 inhibitor everolimus to either fulvestrant or an aromatase inhibitor has also been shown to significantly improve progression-free survival compared with endocrine therapy alone, although again no significant effect on overall survival has been established.14, 15