Overall Survival with Inavolisib in PIK3CA-Mutated Advanced Breast Cancer Quiz

Linda is a 59-year-old postmenopausal woman diagnosed with hormone receptor-positive, HER2-negative advanced breast cancer harboring a confirmed PIK3CA mutation. She has progressed on first-line endocrine therapy and is currently receiving fulvestrant. Her medical history includes well-controlled type 2 diabetes mellitus and hypertension. She presents to the oncology pharmacy to discuss options for next-line therapy.

Question: Based on the latest evidence from the INAVO120 trial, what is the most appropriate recommendation for Linda’s treatment to improve overall survival?

Maria is a 62-year-old woman with HR+/HER2- advanced breast cancer with a PIK3CA mutation, recently started on inavolisib combined with palbociclib and fulvestrant. She has a history of prediabetes but no prior diagnosis of diabetes. Two weeks into therapy, she reports increased thirst and frequent urination. Her fasting blood glucose is 180 mg/dL.

Question: What is the most appropriate pharmacist intervention to manage Maria’s hyperglycemia associated with inavolisib therapy?

James is a 55-year-old man diagnosed with metastatic HR+/HER2- breast cancer. His oncologist is considering targeted therapy options. James has no significant comorbidities and is eager to start treatment. The oncology pharmacist is asked about the importance of molecular testing before initiating therapy.

Question: Why is PIK3CA mutation testing essential before starting inavolisib or alpelisib in HR+/HER2- advanced breast cancer patients?