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Capivasertib

Capivasertib, sold under the brand name Truqap, is an anti-cancer medication used for the treatment of breast cancer.

It is taken by mouth.

It is approved for people with hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer when used in combination with fulvestrant.

Its most common adverse reactions include diarrhea, cutaneous adverse reactions, increased random glucose, decreased lymphocytes, decreased hemoglobin, increased fasting glucose, nausea, fatigue, decreased leukocytes, increased triglycerides, decreased neutrophils, increased creatinine, vomiting, and stomatitis.

A first-in-class medication.

Capivasertib, used in combination with fulvestrant (Faslodex), is indicated for adults with hormone receptor-positive, human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer with one or more PIK3CA/AKT1/PTEN-alterations, as detected by an FDA-approved test, following progression on at least one endocrine-based regimen in the metastatic setting or recurrence on or within twelve months of completing adjuvant therapy.

Capivasertib inhibits 3 isoforms of serine and threonine kinase AKT, specifically AKT1, AKT2, and AKT3, and inhibits downstream phosphorylation of AKT substrates. 

Activation of upstream signaling pathways is the result of AKT activations in tumors, as well as mutations in AKT1, loss of phosphatase and tensin homolog (PTEN) function. 

Mutations in phosphatidylinositol 3-kinase (PIK3CA) can also result in AKT activation. 

Efficacy was evaluated in CAPItello-291 (NCT04305496), a randomized, double-blind, placebo-controlled, multicenter trial in 708 participants with locally advanced or metastatic HR-positive, HER2-negative breast cancer, of which 289 participants had tumors with PIK3CA/AKT1/PTEN-alterations.

All participants were required to have progression on aromatase inhibitor-based treatment.

Participants could have received up to two prior lines of endocrine therapy and up to one line of chemotherapy for locally advanced or metastatic disease.

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