Capivasertib + fulvestrant (HR+/HER2- PIK3CA/AKT1/PTEN-altered metastatic post-AI/CDK4/6i)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Components	`DRUG-CAPIVASERTIB` `DRUG-FULVESTRANT`

ID	`REG-CAPIVASERTIB-FULVESTRANT-BREAST`
Type	Regimen
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-CAPITELLO291-TURNER-2023` `SRC-ESMO-BREAST-METASTATIC-2024` `SRC-NCCN-BREAST-2025`

Notes

CAPItello-291: AKT-pathway-altered (PIK3CA / AKT1 / PTEN) cohort PFS 7.3 vs 3.1 mo (HR 0.50). Pathway-alteration testing (NGS for PIK3CA / AKT1 + combined IHC + NGS for PTEN loss) required pre-start. Intermittent 4-on/3-off dosing intentional — improves tolerability vs continuous (phase 1/2 finding). Diarrhea management dominant clinical workflow burden.

Used By

Handbook Chapters

HB-BREAST-HR-POS-HER2-NEG-1L - HR+/HER2- metastatic breast cancer: first-line reasoning

Indication

IND-BREAST-HR-POS-2L-AKT-CAPIVASERTIB - IND-BREAST-HR-POS-2L-AKT-CAPIVASERTIB