This phase 1b analysis from the ELEVATE study evaluated the combination of elacestrant and capivasertib in patients with ER-positive, HER2-negative advanced breast cancer whose tumors harbored alterations in the PI3K/AKT pathway. The combination demonstrated a manageable safety profile with no new safety concerns and showed encouraging antitumor activity, including durable disease control across a heavily pretreated population. These findings support further investigation of this all-oral regimen as a strategy to simultaneously target endocrine resistance and PI3K/AKT pathway–driven disease.