Clinical Assessment and Pharmacologic Considerations for Diarrhea Management in HR+/HER2-Negative Advanced Breast Cancer

In this segment, Dr. Neil Iyengar leads a practical discussion on how clinicians assess and manage diarrhea associated with PI3K and AKT pathway inhibitors in HR+/HER2-negative advanced breast cancer. The panel first addresses how lower-grade gastrointestinal symptoms are distinguished from more clinically significant diarrhea that may warrant treatment interruption, dose modification, or further diagnostic evaluation. Panelists emphasize the importance of symptom severity, duration, patient-reported impact, and hydration status when making management decisions. The discussion then shifts to pharmacy-specific considerations, with Heather Moore, CPP, PharmD explaining how pharmacokinetic data inform patient counseling around dosing timing and food-related considerations. She highlights how clear guidance on medication administration can help reduce gastrointestinal toxicity and improve tolerability. Together, these perspectives illustrate how clinical assessment and pharmacologic education work in tandem to support early intervention, minimize treatment disruption, and maintain patient adherence during therapy.