Capasertib is an AKT inhibitor, which is currently mainly used to treat hormone receptor positive (HR+) and HER2 negative (HER2-) advanced breast cancer. The recommended dosage is 400 milligrams per dose, taken orally twice a day for 4 consecutive days and stopped for 3 days (i.e. a 4-day medication/3-day rest cycle). During the treatment period, it is necessary to closely monitor adverse reactions such as blood sugar and diarrhea, and adjust the dosage according to toxicity.

1. Usage and dosage

The standard dose of Kapasetinib is 400 milligrams orally, twice daily (with an interval of approximately 12 hours), using an intermittent dosing regimen: taking continuously for 4 days and stopping for 3 days, forming a 7-day treatment cycle. This plan is optimized based on clinical trial data, aiming to balance efficacy and toxicity.

(1) Principle of dose adjustment

If there are grade 2 or above adverse reactions, the medication should be suspended until it returns to ≤ grade 1, and then gradually reduced: the first dose should be reduced to 320 milligrams twice daily, and the second dose should be reduced to 200 milligrams twice daily. If a third dose reduction is still required, the medication will be permanently discontinued.

(2) Medication for special populations

Patients with moderate to severe liver function impairment need to reduce their dosage by 25% -50%, while patients with end-stage renal disease do not require adjustment. The dosage for elderly patients is the same as that for adults, but monitoring needs to be strengthened.

2 Precautions

(1) High blood sugar

The incidence rate is about 13%, and the history of diabetes needs to be screened before use. During the treatment period, fasting blood glucose should be monitored weekly. If it exceeds 250mg/dL, medication should be suspended and insulin therapy should be initiated.

(2) Diarrhea

44% of patients experience diarrhea, with grade 3 accounting for 9%. The medication should be suspended immediately upon the first occurrence of grade 2 diarrhea, and prophylactic use of loperamide is necessary after recovery.

(3) Skin toxicity

The incidence of rash is about 38%, including acne like dermatitis and palmar erythema. It is recommended to use non-alcoholic moisturizers. For grade 3 reactions, treatment should be interrupted and corticosteroids should be applied locally.

(4) Embryotoxicity

There is a risk of teratogenicity, and women of childbearing age should take effective contraceptive measures during treatment and within one month after discontinuing medication. Prohibited during lactation.