{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:24:29Z","timestamp":1791559469369,"version":"4.3.4"},"reference-count":15,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Phosphoinositide 3-kinase\/protein kinase B (AKT) pathway inhibition is an important therapeutic strategy for hormone receptor positive and human epidermal growth factor receptor 2 negative advanced breast cancer. Capivasertib, an oral pan-AKT inhibitor, improves progression-free survival in combination with fulvestrant but is frequently associated with hyperglycemia. Despite this recognized adverse effect, consensus management guidelines are lacking. We describe 3 patients who developed capivasertib-associated hyperglycemia, 2 of whom had severe hyperglycemia with alpelisib therapy, a phosphoinositide 3-kinase inhibitor. Hyperglycemia developed early and was marked by postprandial excursions. All patients were treated with insulin-sensitizing therapies. Preemptive initiation or intensification of antihyperglycemic therapy before capivasertib exposure attenuated hyperglycemia severity. These cases highlight the insulin-resistant phenotype of AKT inhibitor-associated hyperglycemia and support early metabolic assessment, postprandial glucose monitoring, and preferential use of insulin-sensitizing therapies to minimize treatment interruption.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag273","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:13:34Z","timestamp":1788520414000},"source":"Crossref","is-referenced-by-count":1,"title":["Managing capivasertib-induced hyperglycemia: a report of 3 cases"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4438-1047","authenticated-orcid":false,"given":"Katherine","family":"Cuan","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3197-9180","authenticated-orcid":false,"given":"Sun Young","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7064-1873","authenticated-orcid":false,"given":"Jovan","family":"Milosavljevic","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3472-8389","authenticated-orcid":false,"given":"Beatrice Y","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026091603525713500_luag273-B1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.breast.2022.03.018","article-title":"The emerging role of capivasertib in breast cancer","volume":"63","author":"Andrikopoulou","year":"2022","journal-title":"Breast"},{"issue":"9","key":"2026091603525713500_luag273-B2","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2024.103697","article-title":"Capivasertib and fulvestrant for patients with hormone receptor-positive advanced breast cancer: characterization, time course, and management of frequent adverse events from the phase III CAPItello-291 study","volume":"9","author":"Rugo","year":"2024","journal-title":"ESMO Open"},{"issue":"8","key":"2026091603525713500_luag273-B3","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1002\/cam4.4579","article-title":"Characterization, management, and risk factors of hyperglycemia during PI3K or AKT inhibitor treatment","volume":"11","author":"Liu","year":"2022","journal-title":"Cancer Med"},{"issue":"22","key":"2026091603525713500_luag273-B4","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1056\/NEJMoa2214131","article-title":"Capivasertib in hormone receptor-positive advanced breast cancer","volume":"388","author":"Turner","year":"2023","journal-title":"N Engl J Med"},{"key":"2026091603525713500_luag273-B5","doi-asserted-by":"crossref","DOI":"10.1177\/15347354211032283","article-title":"Treating alpelisib-induced hyperglycemia with very low carbohydrate diets and sodium-glucose co-transporter 2 inhibitors: a case series","volume":"20","author":"Blow","year":"2021","journal-title":"Integr Cancer Ther"},{"issue":"24","key":"2026091603525713500_luag273-B6","doi-asserted-by":"crossref","first-page":"3854","DOI":"10.1002\/cncr.34928","article-title":"Incidence, risk factors, and management of alpelisib-associated hyperglycemia in metastatic breast cancer","volume":"129","author":"Shen","year":"2023","journal-title":"Cancer"},{"issue":"6","key":"2026091603525713500_luag273-B7","first-page":"2319","article-title":"The Akt pathway in oncology therapy and beyond (review)","volume":"53","author":"Nitulescu","year":"2018","journal-title":"Int J Oncol"},{"key":"2026091603525713500_luag273-B8","article-title":"Revving the engine: PKB\/AKT as a key regulator of cellular glucose metabolism","volume":"14","author":"Li","year":"2023","journal-title":"Front Physiol"},{"issue":"10","key":"2026091603525713500_luag273-B9","article-title":"Glycemic derangements with capivasertib\u2014from hyperglycemia to diabetic ketoacidosis: a report of 3 cases","volume":"3","author":"Nicolich-Henkin","year":"2025","journal-title":"JCEM Case Rep"},{"issue":"1","key":"2026091603525713500_luag273-B10","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/s41523-024-00613-x","article-title":"Managing hyperglycemia and rash associated with alpelisib: expert consensus recommendations using the Delphi technique","volume":"10","author":"Gallagher","year":"2024","journal-title":"NPJ Breast Cancer"},{"issue":"7719","key":"2026091603525713500_luag273-B11","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1038\/s41586-018-0343-4","article-title":"Suppression of insulin feedback enhances the efficacy of PI3K inhibitors","volume":"560","author":"Hopkins","year":"2018","journal-title":"Nature"},{"issue":"14","key":"2026091603525713500_luag273-B12","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.2169\/internalmedicine.6353-25","article-title":"Characteristic glycemic patterns during capivasertib treatment identified by continuous glucose monitoring: a case report","volume":"65","author":"Takahashi","year":"2025","journal-title":"Intern Med"},{"issue":"4","key":"2026091603525713500_luag273-B13","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s13340-025-00841-x","article-title":"Dynamic changes of blood glucose level during capivasertib treatment in metastatic breast cancer: a case report","volume":"16","author":"Sasada","year":"2025","journal-title":"Diabetol Int"},{"issue":"4","key":"2026091603525713500_luag273-B14","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/jdi.70261","article-title":"Continuous glucose monitoring reveals bimodal glycemic patterns during and outside capivasertib administration","volume":"17","author":"Suzuki","year":"2026","journal-title":"J Diabetes Investig"},{"issue":"1","key":"2026091603525713500_luag273-B15","doi-asserted-by":"crossref","DOI":"10.70352\/scrj.cr.25-0514","article-title":"A case of grade 4 hyperglycemia induced by capivasertib and successfully managed with early insulin intervention","volume":"11","author":"Nomoto","year":"2025","journal-title":"Surg Case Rep"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/10\/luag273\/71115210\/luag273.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/10\/luag273\/71115210\/luag273.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:53:03Z","timestamp":1789545183000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luag273\/8800980"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,9,3]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luag273","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,3]]},"article-number":"luag273"}}