Indication
Breast Cancer advanced or metastatic hormone-receptor positive with PIK3CA/AKT1/PTEN-alterations
Dose
Breast Cancer advanced or metastatic hormone-receptor positive with PIK3CA/AKT1/PTEN-alterations
- Dose – Oral: 400 mg twice daily for 4 consecutive days followed by 3 days off, continuously until disease progression or unacceptable toxicity
- Given in combination with fulvestrant
Supplied
Available as 160 mg and 200 mg film-coated tablets. Tablets should NOT be crushed or broken. Store at room temperature.
Pharmacological Category
Serine/Threonine Kinase AKT Inhibitor
Administration
Take with or without food
Missed Dose
If a dose is missed, patients should be instructed to take it as soon as they can if it is within 4 hours of the missed dose. If it is over 4 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.
Adverse Effects
Common: Diarrhea, Stomatitis, Glucose increase, Hyperglycemia, Cutaneous reactions (including rash, dermatitis, pruritus).
Less Common: Nausea, Headache, Fatigue, Decreased appetite, Neutropenia.
The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.
Monitoring Parameters
Baseline before treatment: CBC & differential, platelets, creatinine, ALT,bilirubin, alkaline phosphatase, fasting glucose, HbA1c.
Fasting glucose: Monitor at weeks 1, 2, 4, 6, 8 and then monthly thereafter. For patients with diabetes, monitor/self-monitor daily for the first two weeks of treatment and then monitor as needed to manage hyperglycemia as per healthcare team.
HbA1C: Every 3 months during treatment. For patient with diabetes, also monitor at week 4.
If clinically indicated: CBC & differential, platelets, creatinine, ALT, bilirubin, alkaline phosphatase, assessment for cutaneous reactions.
Drug Interactions
This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
Current drug interaction databases should be consulted for more information.
Clinical Pearls
Avoid in pregnancy and lactation.
Hyperglycemia can commonly occur with capiversatib and can be severe, occurring more frequently in patients with a baseline HbA1C of 6.5% or higher. More frequent monitoring of blood glucose levels is recommended in patients with diabetes or who are at higher risk for hyperglycemia.
Diarrhea commonly occurs. Severe diarrhea can result in dehydration, electrolyte imbalance, and renal insufficiency. Manage with loperamide.
References
BC Cancer. BCCancer Drug Manual. Capiversatib. Vancouver, British Columbia: BC CancerAgency. Available at:http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Capivasertib_monograph.pdfDeveloped December 1, 2024. Accessed February 19, 2025.
Astra Zeneca. Truqap Product Monograph. In: Health Canada, Drug Product Database. Availableat: https://pdf.hres.ca/dpd_pm/00078178.PDF Updated January 3rd, 2025. AccessedFebruary 19th 2025.
