Capivasertib and Emerging Options in the Post–CDK4/6 Inhibitor Setting

Erica L. Mayer, MD, MPH, of Dana-Farber Cancer Institute, closes with the competitive landscape around capivasertib plus fulvestrant in hormone receptor positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. Seth A. Wander, MD, PhD, of Massachusetts General Hospital, reviews VIKTORIA-1, in which intravenous gedatolisib, a phosphatidylinositol 3-kinase (PI3K)/AKT/mTOR inhibitor, produced median progression-free survival of roughly 7 to 9 months in PIK3CA wild-type disease and 11 to 12 months in PIK3CA-mutant disease as a doublet or triplet, anticipating difficult oral-versus-intravenous conversations if labels overlap with capivasertib. He also highlights evERA, in which oral giredestrant plus everolimus after a cyclin-dependent kinase 4/6 inhibitor showed a signal approaching 10 months in ESR1-mutated disease, an all-oral option he expects to appeal to patients with ESR1-mutant, PIK3CA wild-type tumors. Dr Mayer, joined by Sarah L. Sammons, MD, of the University of Maryland Greenebaum Comprehensive Cancer Center, reflects on weighing survival endpoints in a long-course disease.