Escalation Pathways for Dermatologic Toxicities in HR+/HER2-Negative Advanced Breast Cancer

In this segment, Dr. Neil Iyengar leads a panel discussion on the evaluation and escalation of dermatologic adverse events associated with PI3K and AKT pathway inhibitors in HR+/HER2-negative advanced breast cancer. The panel outlines a structured approach to assessing new-onset rash, emphasizing the importance of differentiating lower-grade, treatment-related dermatologic reactions from presentations that may warrant dermatology consultation or additional laboratory evaluation. Panelists discuss key clinical features that guide decision-making, including rash distribution, severity, progression, and associated systemic symptoms. The conversation then shifts to management strategies for patients who experience recurrent or persistent grade 2 rash, highlighting multidisciplinary escalation pathways that may include intensified topical therapy, treatment interruption, or specialist referral. Throughout the discussion, the panel emphasizes proactive patient education, clear communication of warning signs, and timely reporting to support early intervention, minimize symptom burden, and maintain continuity of therapy.