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Where We Are Today and Where We Are Going: Integrating PI3K/AKT Pathway–Directed Therapies Into Clinical Practice for Hormone Receptor–Positive/HER2-Negative Advanced Breast Cancer

Clinical Thought

Recent advances in breast cancer care are reshaping how experts think about PI3K/AKT pathway–directed therapy for HR-positive/HER2-negative advanced disease. This activity examines current and emerging evidence on biomarker-guided treatment selection, earlier testing for PIK3CA/AKT/PTEN alterations, evolving sequencing strategies after endocrine therapy and CDK4/6 inhibitor exposure, and practical issues such as hyperglycemia management, patient selection, regional access, and multidisciplinary support. Learners will consider how these developments can help move treatment planning from reactive decision-making at progression toward more individualized care.

Released: July 13, 2026

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Provided by Clinical Care Options, LLC dba Decera Clinical Education

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Supporters

Supported by an educational grant from F. Hoffmann-La Roche Ltd.

F. Hoffmann-La Roche Ltd.

Target Audience

This activity is intended for medical oncologists and other healthcare professionals caring for patients with breast cancer.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Describe the rationale for using PI3K/AKT/mTOR pathway inhibitors in HR+/HER2- metastatic breast cancer, including their mechanisms of action and clinical relevance in biomarker-selected populations

  • Develop individualized treatment plans based on biomarker testing, the latest clinical data, and patient-specific factors for patients with HR+/HER2- PIK3CA-mutated mBC

  • Identify patients eligible for PI3Ki therapy through appropriate biomarker testing and assessment of clinical risk factors, including those for treatment-induced hyperglycemia

  • Apply practical, evidence-based strategies for mitigating and managing treatment-related hyperglycemia to optimize adherence and outcomes

Financial Disclosures

Primary Author

Giampaolo Bianchini, MD: consultant/advisor/speaker: AstraZeneca, Amgen, Daiichi Sankyo, Exact Science, Gilead, Helsinn, Lilly, Menarini, MSD, Novartis, Pfizer, Roche, Seagen, Takeda, Tethis; researcher (paid to institution): Gilead.

Cristina Saura Manich, MD, PhD: consultant/advisor/speaker: AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, F. Hoffmann-La Roche, Gilead, Lilly, Novartis, Pfizer, Puma.