Inavolisib, as a PI3K inhibitor, commonly has metabolic abnormalities such as high blood sugar and diarrhea as side effects. In severe cases, it may cause pneumonia or skin toxicity. Most mild reactions can be relieved on their own, but caution should be exercised in cases of worsening infection that require medical intervention.

Regarding the side effects of Inavolisib

1. Common self limiting side effects

(1) Digestive system: Diarrhea (67%), nausea (44%), and vomiting (31%) are usually grades 1-2 and can be relieved through dietary adjustments.

(2) Skin reactions: Rash (58%) and stomatitis (36%) often occur in the early stages of treatment and gradually alleviate within 2 weeks.

2 metabolic abnormalities that need to be monitored

(1) Hyperglycemia: the incidence rate is about 79%. It is necessary to screen the history of diabetes before use, and monitor fasting blood glucose during treatment.

(2) Abnormal liver function: ALT/AST elevation (grade 3 accounts for 11%), it is recommended to test liver enzymes every 2 weeks.

3 serious adverse reactions

(1) Interstitial pneumonia: incidence rate of 4.3%. If coughing/dyspnea occurs, medication should be stopped immediately and imaging examination should be performed.

(2) Severe infection: Increased risk of infection associated with neutropenia, fever ≥ 38 ℃ requiring emergency treatment.

Ways to alleviate side effects

Alleviation of digestive system side effects

(1) Diarrhea: Maintain sufficient water intake, avoid high-fat/high fiber foods, take oral rehydration salts for mild diarrhea, and seek medical attention for persistent or bloody diarrhea.

(2) Nausea and vomiting: Eat in small portions and avoid greasy foods. Doctors may prescribe antiemetic drugs such as ondansetron. Severe vomiting requires intravenous fluid replacement.

2. Management of metabolic abnormalities

(1) High blood sugar: Regularly monitor fingertip blood sugar, adopt a low carbohydrate diet, and the doctor may adjust the glycemic control plan or suspend enalapril.

(2) Elevated liver enzymes: Avoid alcohol and liver damaging drugs, recheck liver function every 2 weeks, and adjust dosage or suspend treatment if grade 3 or above.

3 Skin reaction treatment

(1) Skin rash: Use non irritating skincare products, avoid sun exposure, apply hydrocortisone ointment locally, and take oral antihistamines for extensive skin rash.

(2) Mouthritis: Rinse mouth with salt water after eating to avoid spicy food. Local use of lidocaine gel for analgesia. Antibiotics are required for severe cases.

4 Infection Prevention and Response

(1) Daily protection: Wash hands frequently, avoid contact with infected individuals, seek medical attention immediately if fever occurs, and G-CSF treatment may be necessary when neutrophils decrease.

(2) Respiratory symptoms: Newly developed cough/dyspnea requires chest CT scan for interstitial pneumonia, and glucocorticoid treatment is needed after diagnosis.

5 Special Precautions

(1) During the medication period, it is prohibited to receive live vaccines. Please confirm with your doctor the appropriate time to receive inactivated vaccines.

(2) Efficient contraceptive measures should be taken during the reproductive age period, and pregnancy should be avoided during treatment and within one month after discontinuation of medication.