The ongoing Targeting Insulin Feedback to Enhance Alpelisib (TIFA) trial (NCT05090358) is examining the effects of ketogenic diet, low-carbohydrate diet, or SGLT2i therapy in preventing hyperglycemia in patients with HR+, HER2–, PIK3CA-mutated ABC treated with alpelisib52. The gene discussed is PIK3CA; the disease is Hyperglycemia.