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June 15, 2017. The BELLE-2 trial published this month in Lancet Oncology shows that PI3K inhibition using buparlisib in addition to fulvestrant improves progression-free survival (PFS) in postmenopausal women with aromatase inhibitor-resistant ER(+), HER2(-) breast cancer. 1147 women were randomized to fulvestrant +/- buparlisib with the experimental cohort achieving a significant PFS advantage of 2 months (3 months among patients with known activation of the PI3K pathway). But buparlisib did a number on the liver causing many people to discontinue therapy after very short exposure times. Looks like we still have some work to do before we tame the beast.