HR-Positive Metastatic Breast Cancer — Year in Review Series on Relevant New Datasets and Advances in the PI3K/AKT/mTOR Pathway

PI3K, AKT, and mTOR pathway inhibitors represent a rapidly evolving treatment landscape for hormone receptor-positive metastatic breast cancer. Recent clinical data highlights the efficacy of agents like Gedatolisib, which targets both PI3K and mTOR, alongside established therapies such as Capivasertib and Alpelisib. Managing treatment-related toxicities, specifically hyperglycemia and stomatitis, remains critical for maintaining patient compliance and achieving optimal outcomes. Clinicians now emphasize proactive management strategies, including the use of GLP-1 agonists for glucose control and steroid mouthwashes for stomatitis. As treatment paradigms shift toward second-line targeted therapies following CDK4/6 inhibitor progression, the integration of biomarker testing—via both tissue and liquid biopsies—is essential for identifying actionable mutations. Ongoing research into triplet combinations and novel agents continues to expand therapeutic options, aiming to delay the need for chemotherapy while improving overall survival in patients with endocrine-resistant disease.