This is Part 3 of Shared Decisions, Better Outcome: Collaboration in Managing Targeted Therapy for HR-Positive/HER2-Negative Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable.

 

In this video, Erika Hamilton, MD, Melissa Rikal, MSN, FNP-BC, AOCNP®, and Heather Moore, CPP, PharmD, discuss collaborative strategies for managing capivasertib toxicities in breast cancer. The patient is a 67-year-old woman with de novo hormone receptor–positive, HER2-negative metastatic breast cancer whose disease progressed on letrozole plus ribociclib and was found to have a PIK3CA mutation on next-generation sequencing. Notable comorbidities include diet-controlled type 2 diabetes, chronic kidney disease, GERD, and a prior history of eczema.

 

The faculty highlight proactive strategies to lessen the impact of toxicities, including the use of metformin or SGLT2 inhibitors to mitigate hyperglycemia and prophylactic antihistimines or topical steroids to help manage rashes. They also address how comorbidities such as chronic kidney disease influence antihyperglycemic drug selection, the importance of drug interaction awareness, grading toxicities by body surface area involvement, and the careful sequencing of holds and dose reductions to keep patients on effective therapy long-term.