A first-in-human study reported initial safety and survival signals for roginolisib, a conformation-selective PI3Kδ inhibitor, in advanced cancers. The trial found the agent well tolerated, with median overall survival reaching up to 20.8 months in metastatic uveal melanoma, alongside immune profile changes consistent with relief of tumor-induced immunosuppression. The study is notable for linking target-selective PI3Kδ pharmacology with measurable immunologic effects in patients, a step toward rational combinations in PI3K-pathway oncology. While early-stage by design, the survival signal in metastatic uveal melanoma provides a concrete dataset to guide dose selection and next trial strategies for PI3Kδ programs targeting the immune tumor microenvironment.