Proactive Monitoring and Timely Treatment Can Help Patients Continue Cancer Therapy Safely.Hyperglycemia, or high blood sugar, can occur during treatment with capivasertib, a targeted therapy used for certain patients with advanced breast cancer. Evidence from clinical trials and real-world research suggests that blood sugar changes can be managed through early preparation, regular monitoring, and timely treatment.
The findings from the CAPItello-291 clinical trial showed that approximately 37% of patients experienced an increase in fasting glucose levels from their baseline. The median time to the first occurrence was 15 days after starting treatment. However, only 0.6% of patients required a dose reduction, and another 0.6% permanently discontinued treatment because of hyperglycemia.
The results highlight the importance of monitoring blood sugar levels, particularly during the early stages of capivasertib therapy.
A recent US real-world observational study involving patients with metastatic breast cancer also found that hyperglycemia and the need for blood sugar-lowering medicines were less common with capivasertib than with other inhibitors targeting the PI3K/AKT pathway.
Early Monitoring and Management Are Essential
Healthcare professionals can take several steps to reduce the risk of serious blood sugar elevations during capivasertib treatment. These include assessing patients’ blood glucose levels before treatment begins, identifying existing risk factors, and providing clear guidance on monitoring and managing high blood sugar.
Fasting glucose levels should be checked regularly, and patients should be informed about the symptoms of hyperglycemia. If blood sugar rises, doctors may start metformin or increase its dose, depending on the patient’s condition and clinical needs.
In certain situations, capivasertib may need to be temporarily withheld until fasting glucose levels fall to 160 mg/dL or below. Treatment can then be resumed according to the recommended guidelines and the patient’s glucose levels. Some of these recommendations are based on expert panel consensus.
Supporting Treatment Continuity
The guidance emphasizes a proactive approach beginning before Day 1 of treatment. By combining regular monitoring, timely medication adjustments, and appropriate dose management, healthcare teams can help control hyperglycemia while supporting patients in continuing their cancer treatment.
Overall, the evidence suggests that although blood sugar elevations are a potential concern with capivasertib, appropriate prevention and management strategies can help address this side effect and support safer treatment.
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