Topics:
Breast Cancer • Medical Oncology • HR+ • Journal Club ft. NEJM publications • Breast Cancer, Metastatic
How do you define PIK3CA/AKT/PTEN alteration for capivasertib use?
Patient with stage IV ER+PR+Her2- breast cancer progressed after CDK4/6 inhibitor+AI and then on Elacestrant. Guardant 360 showed ESR1 mutation and PIK3CA amplification. Does PIK3CA amplification qualify for the definition of PIK3CA/AKT/PTEN alteration for use of capivasertib?
Answer from: Medical Oncologist at Academic Institution
For CAPItello-291, tumors had to have activating mutations in PIK3CA or AKT or inactivating alterations in PTEN genes – i.e., genes that were altered/not normal. Gene amplification refers to an increase in the number of copies of the same, normal gene, not an increased rate of transcription. S...
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Answer from: Medical Oncologist at Academic Institution
Currently, I am only considering activating mutations in PIK3CA/AKT as well as PTEN alterations for capivasertib use. These are the types of changes that were considered “eligible” in CAPItello-291 for the “pathway altered” analysis. That being said, there was a signal of ben...