Endocrine and targeted therapy for hormone receptor–positive, human epidermal growth factor receptor 2–negative metastatic breast cancer—Capivasertib-Fulvestrant: ASCO rapid recommendation update

Endocrine and targeted therapy for hormone receptor–positive, human epidermal growth factor receptor 2–negative metastatic breast cancer—Capivasertib-Fulvestrant: ASCO rapid recommendation update - American Society of Clinical Oncology (ASCO)

ASCO Rapid Recommendation Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options. Guidelines and updates are not intended to substitute for independent professional judgment of the treating provider and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only).


Background: Patients with hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative metastatic breast cancer (MBC) have emerging therapeutic options including novel endocrine1 and targeted agents, with treatment informed by genomic biomarker testing. The CAPItello-291 phase III, double-blind, randomized controlled trial (RCT) evaluating fulvestrant with the AKT pathway inhibitor capivasertib and subsequent US Food and Drug Administration approval of capivasertib and a companion diagnostic device on November 16, 2023, constituted strong signals for updating ASCO MBC guidelines.


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