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Although it showed good brain penetrance and tolerability in a phase 2 trial for rGB with PI3K pathway activation mutations, its efficacy was limited, with only a small fraction of patients achieving PFS at six months ( Another therapeutic approach involved the mTOR inhibitors temsirolimus and everolimus, both of which have been extensively evaluated in GB in various clinical settings
Common next steps may include: Further investigation with an OGTT or fasting plasma glucose test where clinically indicated Assessment for PCOS , metabolic syndrome, or metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD), including cardiometabolic risk stratification If insulinoma or another cause of endogenous hyperinsulinism is suspected, endocrinology referral is essential
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