Monitoring insulin levels and treating high insulin and blood sugar in breast cancer patients using pioglitazone.

A Pilot Study of Monitoring Insulin Levels and Treating Hyperinsulinemia and Hyperglycemia With Pioglitazone in Patients Treated With Alpelisib for Metastatic Breast Cancer.

Early Phase 1 Interventional Rambam Health Care Campus · NCT05753657

This study is testing if using pioglitazone to manage insulin and blood sugar levels can help women with metastatic breast cancer who are being treated with Alpelisib.

Quick facts

PhaseEarly Phase 1
Study typeInterventional
Enrollment30 (estimated)
Ages18 Years to 85 Years
SexFemale
SponsorRambam Health Care Campus Academic / other
Locations1 site (Haifa)
Trial IDNCT05753657 on ClinicalTrials.gov

What this trial studies

This pilot study aims to evaluate the feasibility and safety of monitoring insulin and glucose levels in patients with metastatic breast cancer who are being treated with Alpelisib. It will investigate the use of pioglitazone to manage hyperglycemia and hyperinsulinemia in these patients. The study will also assess the rates of glycemic control, treatment discontinuation, dose reductions, and progression-free survival associated with this treatment approach.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18-85 with ER positive HER2 negative metastatic breast cancer and a PIK3CA mutation, who are starting treatment with Alpelisib.

Not a fit: Patients with uncontrolled diabetes, gastrointestinal issues affecting drug absorption, or those allergic to pioglitazone may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a new management strategy for metabolic side effects in breast cancer patients undergoing treatment.

How similar studies have performed: While this approach is novel, similar studies have shown promise in managing metabolic side effects in cancer treatments.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients with ER positive HER2 negative metastatic breast cancer, harboring an activating PIK3CA mutation, scheduled to start treatment with Alpelisib and fulvestrant.
* Ages 18 - 85
* ECOG performance status 0, 1 or 2
* Ability to understand and willingness to sign a written informed consent.

Exclusion Criteria:

* Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of Alpelisib
* Uncontrolled diabetes mellitus, defined as HbA1c above 8%
* Diabetes mellitus controlled by insulin
* Uncontrolled intercurrent illness including, but not limited to: active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
* Pregnancy
* Known allergy to pioglitazone

Where this trial is running

Haifa

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Metastatic Breast CancerHyperinsulinismHyperglycemia Drug Induced
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.