Adverse Event Management in HR+/HER2– Advanced Breast Cancer: PI3K/AKT/PTEN Pathway

Panelists discuss how biomarker testing plays a critical role in hormone receptor–positive, HER2-negative advanced breast cancer, emphasizing the timing of testing, the relevance of specific genomic assays, and the significant impact on prognosis and treatment decisions.

Panelists discuss how to approach selecting first-line treatment options for hormone receptor–positive, HER2-negative advanced breast cancer by providing an overview of standard-of-care options and highlighting the primary considerations that guide treatment selection.

Panelists discuss how aberrations in the PI3K/AKT/PTEN pathway drive treatment resistance and disease progression following first-line therapy in hormone receptor–positive, HER2-negative advanced breast cancer, emphasizing the critical role of repeat biomarker testing to guide ongoing treatment strategies and enhance patient outcomes.

Panelists discuss the findings of the CAPItello-291 trial, which investigated capivasertib combined with fulvestrant in advanced hormone receptor–positive, HER2-negative breast cancer, leading to its approval in November 2023 and highlighting its potential as a new targeted therapy option in the second-line setting due to the prevalence of PIK3CA, AKT1, and PTEN alterations.

Panelists discuss their clinical experiences with capivasertib, focusing on patient tolerability and the management of adverse effects associated with this targeted therapy.

Panelists discuss the strategies they employ to manage adverse events in patients starting capivasertib, including minimizing the risk of diarrhea through dietary considerations and patient education, as well as approaches for monitoring and managing rash associated with the treatment and providing education about it.

Panelists discuss their approach to monitoring and managing hyperglycemia in patients receiving capivasertib and providing education about it, including when to involve endocrinology and how management strategies may differ for patients with preexisting diabetes.

Panelists discuss the key advice they would offer to fellow physicians, nurse practitioners, advanced practice providers, and pharmacists involved in the care of patients on capivasertib, emphasizing best practices for patient management and communication.