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Male or female participants aged ≥2 years at the time of informed consent\u002Fassent.\n2. Participants with diagnosis of PROS (according to Clinical Diagnostic Criteria for PROS proposed by Keppler Noreuil et al 2014) with symptomatic AND progressive overgrowth, who have syndromic disease or isolated features (with the exception of isolated macrodactyly, macrocephaly or epidermal nevus) at the time of informed consent\u002Fassent.\n3. Documented evidence of a somatic mutation(s) in the PIK3CA gene performed in local laboratories using a DNA-based test AND available archival tissue (if archival tissue sample is not available, a fresh biopsy should be performed, if it is not clinically contraindicated) at the time of informed consent\u002Fassent.\n4. Karnofsky (in participants \\>16 years of age at study entry) or Lansky (≤16 years of age at study entry) performance status index ≥50.\n5. PGI-S score of mild, moderate, severe, or very severe at screening.\n6. Adequate bone marrow and organ function.\n7. Presence of at least 1 PROS-related measurable lesion (longest diameter ≥2 cm) confirmed by BIRC assessment and associated with complaints, clinical symptoms or functional limitations affecting the participant's everyday life.\n\nKey Exclusion Criteria:\n\n1. Participant with only isolated macrodactyly, epidermal nevus\u002Fnevi and macroencephaly (the only clinical feature or a combination of any of three of them), in absence of other PROS-related lesions at the time of informed consent\u002Fassent.\n2. Previous treatment with alpelisib and\u002For any other phosphatidylinositol 3-kinase (PI3K) inhibitor(s) (except treatment attempt, defined as the attempt to treat PROS with any of PI3K inhibitors, with treatment duration less than 2 weeks and stopped at least 4 weeks prior to the first dose of study medication with alpelisib).\n3. Debulking or other major surgery performed within 3 months at the time of informed consent\u002Fassent.\n4. 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