Topics:
Breast Cancer • Medical Oncology • HR+ • Journal Club ft. NEJM publications • Breast Cancer, Metastatic
Would you offer capivasertib+fulvestrant in a patient with metastatic HR+ HER2 negative breast cancer with PTEN mutation who has progressed on fulvestrant plus ribociclib?
Answer from: Medical Oncologist at Community Practice
Patients who received prior Faslodex were excluded from the CAPItello-291 trial. I guess if you're being a purist you'd have to say no. Just thinking out loud: I don't see updated results, but there was a cohort (cohort B) in the BYLieve trial that was studying letrozole + Alpelisib in patients...
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Answer from: Medical Oncologist at Academic Institution
Strictly speaking, prior fulvestrant was not allowed in CAPItello-291. Also, only 5% of patients in CAPItello-291 had PTEN gene alterations assessed by NGS. With that said, if there were no other targeted non-chemo options, I may consider it. This is an extrapolation from a small retrospective study...
Answer from: Medical Oncologist at Academic Institution
Yes, I would offer capivasertib/fulvestrant to a patient with PTEN mutation who has progressed on prior fulvestrant/ribociclib. Such patients are not represented in CAPItello-291 as prior fulvestrant treatment was an exclusion criteria however, with capivasertib being the most targeted and specific ...