Fig. 3.

Management of alpelisib-associated skin AEs (severity based on CTCAE v5.0) [66,70]. AE, adverse event; BID, twice daily; BSA, body surface area; CTCAE, Common Terminology Criteria for Adverse Events; GABA, gamma-aminobutyric acid; IV, intravenous; PI3Ki, phosphatidylinositol-3-kinase inhibitor; TID, thrice daily. ^aTriamcinolone 0.1% or fluocinonide 0.05% BID for ≥28 days. ^bCetirizine 10 mg or loratadine 10 mg or fexofenadine 180 mg BID. ^cDiphenhydramine 25–50 mg or hydroxyzine 25 mg at bedtime. ^dGabapentin 300 mg TID or pregabalin 50 mg BID. ^ePrednisone 0.5–1 mg/kg/daily or equivalent for 7–10 days for grade 3 rash. ^fIf feasible, consider a graded rechallenge with alpelisib starting at 50 mg/day, increasing by 50 mg/week until a 250-mg dose is achieved; start trimethoprim/sulfamethoxazole 160 mg/800 mg three times a week plus a proton pump inhibitor during graded rechallenge (continue oral corticosteroid).