乳腺癌PI3K/AKT抑制剂治疗相关高血糖规范化管理中国专家共识(2026年版)OA

Breast cancer is the most common malignancy among women in China,with approximately 70%of cases being hormone receptor(HR)-positive.Although current therapeutic strategies have significantly improved patient outcomes,endocrine resistance remains a major clinical challenge.Hyperactivation of the phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)signaling pathway is one of the key mechanisms underlying this resistance.In Chinese patients with HR-positive breast cancer,genomic alterations in PIK3CA,AKT1,or PTEN are present in approximately 60%of cases.With the recent approval of the PI3Kα inhibitor inavolisib and the pan-AKT inhibitor capivasertib in China,hyperglycemia,the most frequent mechanism-based adverse effect of these agents,has become a critical focus of clinical management.Based on a comprehensive evaluation of existing evidence-based medicine and clinical practice experience,the expert consensus panel of Chinese expert consensus on standardized management of PI3K/AKT inhibitor-associated hyperglycemia in breast cancer(2026 edition)systematically elaborates on clinical management strategies for PI3K/AKT inhibitor-associated hyperglycemia in breast cancer.A total of 8 recommendations have been formulated,covering:the underlying mechanisms and incidence(Recommendation 1),risk assessment and management goals(Recommendations 2-3),management measures(Recommendations 4-6),multidisciplinary collaboration(Recommendation 7),and patient education and follow-up(Recommendation 8).This consensus aims to provide standardized recommendations for the early identification,monitoring,and management of hyperglycemia in breast cancer patients receiving PI3K/AKT inhibitors,thereby ensuring treatment safety and efficacy.This consensus has been registered on the Practice guideline REgistration for transPAREncy(PREPARE)platform(No.PREPARE-2026CN357).