PIQRAY, also known by its generic name alpelisib, is a prescription medication used in the treatment of advanced or metastatic breast cancer. Specifically, it is indicated for patients whose cancer is hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), and harbors a PIK3CA mutation, as determined by an FDA-approved test. PIQRAY works by inhibiting the activity of the PI3K pathway, a signaling pathway known to play a significant role in the growth and spread of cancer cells. It is typically used in combination with fulvestrant, another cancer medication, after the disease has progressed following an endocrine-based regimen. By targeting the PI3K pathway directly, PIQRAY helps to slow the progression of the disease and may improve survival rates in the selected patient population. Like all medications, it can cause side effects, and its use should be closely monitored by a healthcare professional.