1. What is capivasertib?
Capivasertib is a targeted therapy. Targeted therapies block the growth and spread of cancer. They target and interfere with processes in the cells that help cancer grow.
Capivasertib belongs to a group of drugs called AKT inhibitors.
You may hear it called by its brand name Truqab.
Capivasertib is given alongside the hormone therapy drug fulvestrant.
2. Who might be offered capivasertib?
You may be offered capivasertib if you have or that is:
· And has 1 or more mutations in the PIK3CA, AKT1 or PTEN genes
Before having capivasertib, you should already have had at least 1 hormone therapy.
Capivasertib is not given for .
3. How capivasertib works
In breast cancers with PIK3CA, AKT1 or PTEN gene mutations, a protein called AKT helps the cancer cells grow and divide.
Capivasertib blocks the action of AKT, to help stop the growth and spread of the cancer.
4. How capivasertib is taken
Life during treatment
Going through breast cancer treatment can affect you physically and emotionally. Read our tips to help you cope.
You take capivasertib as a tablet twice a day for 4 days followed by a 3-day break. This is known as a cycle.
You then repeat the cycle
You should swallow the tablets whole. Do not chew, crush or split the tablets before swallowing. Do not take a tablet that’s broken, cracked or damaged.
The recommended dose for most people is 400mg each day, taken as two 200mg tablets twice a day about 12 hours apart. It’s best to take it at the same time every day.
You take capivasertib alongside fulvestrant.
Fulvestrant is given as 2 injections, 1 in each buttock. They are usually given every 14 days for the first 3 doses, then every 28 days for as long as you are having capivasertib.
What if I miss a dose?
If you miss a dose, you can take capivasertib immediately within 4 hours after the time you usually take it.
After more than 4 hours, skip the dose. Take the next dose at your usual time. There should be at least 8 hours between doses.
If you are sick (vomit) after taking capivasertib, do not take an extra dose. Take your next dose at your usual time.
How long will I take capivasertib?
You’ll have capivasertib for as long as your treatment team feels you’re benefiting from the drug and any side effects are manageable.
Capivasertib and menopause
Fulvestrant is suitable for women who have been through the menopause (when your periods stop).
If you have not been through the menopause, you will also have treatment to stop your ovaries producing oestrogen, either temporarily or permanently. This is known as ovarian suppression.
5. Side effects of capivasertib
Like any treatment, capivasertib can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. These side effects can usually be managed and those described here will not affect everyone.
Because it’s given alongside fulvestrant, you may have side effects from that drug too.
Your treatment team can often change the dose of a drug to suit you and to help manage its side effects. This can sometimes help you stay on a treatment for longer.
You should be given a 24-hour contact number or told who to contact if you feel unwell or are concerned about side effects at any time, including at night or at the weekend.
Common side effects
Raised blood sugar levels
Capivasertib can cause your blood sugar levels to increase (hyperglycaemia).
Let your treatment team know if you’re more thirsty or peeing more often than usual.
Other symptoms may include:
- Feeling more tired than usual
- Increased appetite but with weight loss
- Confusion
- Feeling sick (nausea)
- Being sick (vomiting)
- A fruity smell on your breath
- Difficulty breathing
- Flushed skin
You’ll have regular blood tests to check your blood sugar levels.
Skin changes
Capivasertib may cause skin changes. Some of them may be severe, including:
- Dry skin
- Rash
- Blistering
- Itching
- Reddening of the skin
Let your treatment team know if you have any skin changes. They can prescribe medication to help manage them.
It may help to:
- Use a moisturiser regularly and avoid perfumed products
- Wear gloves when washing up, using harsh detergents, gardening or cooking
- Rinse and dry your hands carefully, particularly after contact with cleaning products
- Pat your skin dry with a soft towel, rather than rubbing vigorously
- Take care when shaving
- Wear cotton clothes where possible and wash clothes with mild detergent
Diarrhoea
Diarrhoea is a very common side effect of capivasertib and can sometimes be severe.
Your treatment team or GP may prescribe anti-diarrhoea medication to take home.
If you have diarrhoea, it’s recommended you start the anti-diarrhoea medication straight away, drink plenty of fluids and contact your treatment team.
If you develop severe diarrhoea while taking capivasertib, your treatment team may reduce the dose or stop your treatment.
Nausea and vomiting
You may feel sick (nausea) and be sick (vomit).
Your treatment team can prescribe anti-sickness drugs to help with this. If you’re still feeling sick and being sick, contact your treatment team as they may be able to prescribe a different anti-sickness drug.
Loss of appetite
You may not feel like eating, especially if you feel sick.
Your sense of taste can also change, and some foods and drinks may taste different.
It might help to eat small meals regularly and drink plenty of fluids. You can ask your GP or treatment team to refer you to a dietitian for more advice.
Find out more about diet and breast cancer treatment.
Effects on the blood
Capivasertib can temporarily affect the number of blood cells in the body. Blood is made up of red cells, white cells and platelets.
You’ll have regular blood tests. If these show the number of blood cells is too low, your next cycle of treatment may be delayed or the dose of capivasertib reduced.
Risk of infection
Not having enough white blood cells can increase the risk of getting an infection.
Signs of an infection
Your treatment team may give you guidelines to follow for reporting signs of an infection. But generally you should contact your hospital immediately if you have any of the following:
- A high temperature (over 37.5°C) or low temperature (under 36°C)
- Suddenly feeling unwell, even with a normal temperature
- Symptoms of an infection, such as a sore throat, cough, needing to pee often or feeling cold or shivery, even if you do not have a high temperature
Before starting capivasertib you should be given a 24-hour contact number or told who to contact if you feel unwell at any time during your treatment, including overnight or at the weekends.
You may need treatment if you get an infection.
Anaemia
Having too few red blood cells is called anaemia. If you feel breathless, dizzy or particularly tired, let your treatment team know.
Extreme tiredness (cancer-related fatigue)
Cancer-related fatigue is one of the most common symptoms in people with secondary breast cancer.
Fatigue is extreme tiredness that does not go away with rest or sleep. It has many causes, from the emotional impact of a diagnosis to side effects of treatment or growth and spread of the cancer.
Fatigue may affect how you cope with your cancer and its treatment. It can also make everyday activities harder and affect your quality of life.
Find out more about managing fatigue.
Sore mouth
Looking after your mouth, including your teeth and gums, is very important during treatment.
You’ll be given mouthwash to try to reduce soreness and stop mouth ulcers developing. It’s a good idea to use a small, soft toothbrush during this time.
See your dentist for a check-up before treatment with capivasertib begins. Avoid dental work during treatment if possible.
If you do need to have dental work during treatment, talk with your treatment team about the best time to have this.
If you’re having difficulty registering with a dentist, let your treatment team know.
Less common side effects
Indigestion
Capivasertib can cause indigestion or heartburn, which is a burning feeling in the lower chest.
Let your treatment team know if you have these side effects. They can prescribe medication and give you information about diet to help manage them.
6. Other important information
Allergic reaction
Allergic reactions to capivasertib can occasionally happen. Reactions can vary from mild to severe.
If you have an allergic reaction to capivasertib, it’s more likely to happen the first time you have the treatment.
Contact your hospital immediately if you notice any of the following symptoms:
- Itchy red or discoloured bumps on your skin (these may be harder to see on black or brown skin)
- Swelling in your lips, tongue or throat
- Breathlessness, wheezing, a bad cough or sudden difficulty breathing
- Tight chest or chest pain
Blood clots
People with breast cancer have a higher risk of blood clots such as a DVT (deep vein thrombosis).
If you have a DVT, there’s a risk part of the blood clot could break away and travel to the lung. This is known as a pulmonary embolism (PE).
Blood clots can be life-threatening and should be treated quickly.
Blood clot symptoms
Contact your treatment team or go to your local A&E department straight away if you have any of the following symptoms:
- Pain, redness/discolouration of the skin, heat and swelling of the arm or leg
- Swelling, redness or tenderness where a central line is inserted to give chemotherapy, for example in the arm, chest area or up into the neck
- Shortness of breath that comes on suddenly
- Pain or tightness in the chest
- Unexplained cough or coughing up blood
Some symptoms may look different on different skin tones.
Find out more about blood clots.
Can I take capivasertib with other drugs?
There are a number of drugs that can affect the way capivasertib works. Capivasertib can also affect the way some other medicines work.
If you’re taking any other prescribed or over-the-counter medicines, let your treatment team know.
Diet and secondary breast cancer
Learn about diet and secondary breast cancer, including whether you need supplements and how to manage changes to your diet.
Herbal medicines, supplements and foods
When taking capivasertib:
- Do not take anything containing St John’s wort
- Do not eat grapefruit or drink grapefruit juice
Many people consider taking herbal products or supplements while having treatment for breast cancer. However, the exact effect and safety of taking these after a diagnosis of breast cancer is not fully understood.
Ask your treatment team or pharmacist before taking herbal products or supplements.
Sex and contraception
It’s important not to get pregnant when having capivasertib as it may harm a developing baby.
You’ll be advised to use an effective barrier method of contraception such as condoms or female condoms (Femidoms) during treatment and for at least 4 weeks after the last dose for women and 16 weeks for men.
If you have not been through the menopause, talk to your treatment team about the most suitable method of contraception for you. Some women can still become pregnant even if their periods are irregular or have stopped.
Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes.
Fertility
It’s not clear whether capivasertib affects fertility.
If you were diagnosed with locally advanced or secondary breast cancer before you started or completed a family, you may be concerned about your fertility. You can talk to your treatment team about any possible fertility preservation options before starting treatment.
Breastfeeding
Breastfeeding is not recommended while having capivasertib and fulvestrant. This is because there’s a risk the drugs could be passed on through breast milk.
Travel and vaccinations
If you’re planning a holiday or need to travel overseas, check with your treatment team first.
You should not have any live vaccines while you’re having treatment.
For more information about vaccines, including COVID-19 and flu vaccines, see our information on vaccines and breast cancer.
7. Further support
If you’ve been diagnosed with secondary breast cancer, you might be feeling lonely or isolated. Many people experience this and support is available.
Some people find it helps to talk to someone who has been through the same experience as them. You might find it helpful to join one of our chat groups or visit our confidential online forum.
Our Living with Secondary Breast Cancer services are also here for you. Choose the type of support that suits you and you’ll be able to talk, listen and learn with people who understand the challenges that secondary breast cancer can bring. Find out more below.
