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Written By: Nitin Goswami, Senior Medical Content Writer | Medically Reviewed By: Shilpi Banerjee, Registered Pharmacist (M.Pharm)
Quick answer: Truqap (capivasertib) is a tablet for adults with hormone receptor (HR)-positive, HER2-negative locally advanced or metastatic breast cancer that has a PIK3CA, AKT1, or PTEN alteration and has progressed on at least one hormone-based treatment. It is taken together with fulvestrant, and it is also approved with abiraterone and prednisone for PTEN-deficient metastatic hormone-sensitive prostate cancer. In the CAPItello-291 trial, 40.8% of patients had one of these alterations. Truqap isn't sold in India yet, but it can be accessed legally through a Named Patient Program with a valid prescription and biomarker results.
Last reviewed: September 24, 2026. Every figure in this guide is sourced in the References section at the end.
Somewhere between the biopsy and the follow-up appointment, most people hear a string of terms that sound nothing like plain English — HR-positive, HER2-negative, and now maybe PIK3CA, AKT1 or PTEN mutation too. It's a lot to take in, especially when you're already dealing with a diagnosis. Here's the reassuring part: this is the most common type of breast cancer there is, doctors understand it well, and even when it stops responding to the usual hormone therapy, there's now a targeted option — Truqap (capivasertib) — built specifically for people whose cancer carries one of these mutations. This guide is meant to walk you through it at a human pace: what your diagnosis actually means, what the tests are checking for, and what treatment looks like if you ever need to move beyond the first line of therapy.
| Brand name | Truqap |
|---|---|
| Generic name | Capivasertib |
| Drug class | AKT inhibitor, a targeted kinase inhibitor |
| Manufacturer | AstraZeneca |
| Form and strengths | Film-coated tablets of 160 mg and 200 mg |
| U.S. approval | First approved in 2023. The breast cancer approval came in November 2023, and the prostate cancer approval in 2026 |
| Approved uses | With fulvestrant for HR-positive, HER2-negative locally advanced or metastatic breast cancer with one or more PIK3CA/AKT1/PTEN alterations, after progression on at least one hormone-based treatment. With abiraterone and prednisone for PTEN-deficient metastatic hormone-sensitive prostate cancer |
| Required test | A PIK3CA, AKT1, or PTEN alteration (or PTEN deficiency for prostate cancer) found with an FDA-authorized test |
| Dose in breast cancer | 400 mg twice a day for 4 days, then 3 days off, repeating weekly, together with fulvestrant |
| Key trial | CAPItello-291 (New England Journal of Medicine, 2023) |
| Access in India | Truqap isn't sold in India yet. It can be accessed through a Named Patient Program with a valid prescription and biomarker results (see the Truqap product page) |
Breast cancer isn't one single disease — it's really a family of conditions, and your pathology report is what tells your doctor which member of that family you're dealing with. Two results in particular do the heavy lifting:
Being "HR-positive, HER2-negative" simply means your cancer feeds on hormones but isn't driven by HER2. It's genuinely good news in relative terms — it's the most common subtype, making up about two out of every three breast cancer diagnoses, and it usually responds well to hormone-blocking treatment, at least for a good while.
Numbers can't tell you what will happen in your case, but they do show how common this diagnosis is and how far treatment has come. Every figure below names its source and year.
India's own registry program (ICMR-NCRP) estimated about 1.46 million cancer cases for 2022 and also lists breast cancer as the leading cancer in women. Different agencies use different methods and years, so their totals differ slightly; each figure above sticks to one named source.
(Relative survival compares women with the cancer to the general population. These figures describe groups of patients diagnosed years ago, not any one person's outlook.)
That trial group is a selected one, so the share in your own case can only be found through testing — which is why the biomarker report matters so much for the treatment plan.
If you're wondering "did I do something wrong" or "could I have caught this earlier," the honest answer is usually no — most cases aren't traceable to one clear cause. What doctors do look at includes:
A lot of people are diagnosed after a completely routine mammogram, before they've noticed anything unusual at all — which is exactly the point of screening. But it's still worth knowing your own body and getting checked if you notice:
Most breast changes turn out to be nothing serious. But "probably nothing" is still worth a five-minute conversation with your doctor rather than months of wondering.
The path usually starts with a mammogram or ultrasound, then a core needle biopsy to get a definite answer and pin down your hormone receptor and HER2 status. If the cancer is advanced or has spread, your doctor will likely also send a sample for biomarker testing — checking specifically for PIK3CA, AKT1 or PTEN mutations. That one test result can quietly become one of the most important pieces of information in your entire treatment plan, since it's what opens the door to targeted therapy like Truqap.
In broad strokes, staging looks like this:
Think of these three genes as sitting on the same internal wiring — when any one of them short-circuits, it can keep sending a "grow" signal to the cancer cells even while your hormone therapy is trying to shut that signal down. That's often the real reason a treatment that used to work suddenly stops working. Finding out which gene is affected gives your doctor a precise target instead of a guess.
Most people start with a combination of hormone-blocking therapy (like an aromatase inhibitor or fulvestrant) and a CDK4/6 inhibitor, and for a good stretch of time, it usually works well. Eventually, though, many cancers find a way around it and start growing again — and that's the point where a targeted option is worth exploring rather than simply trying another hormone drug.
If your biomarker test comes back positive for a PIK3CA, AKT1 or PTEN change and your cancer has stopped responding to hormone therapy, Truqap (capivasertib), combined with fulvestrant, is built to go after that exact mutated pathway rather than just rotating to another hormone-blocking drug.
In plain terms, capivasertib blocks a protein called AKT — the same protein that PIK3CA, AKT1 and PTEN mutations end up switching on. By shutting AKT down, it interrupts the growth signal at its source, even in cancer that has already learned to ignore hormone therapy.
The most commonly reported effects are diarrhea (often the first thing people notice), high blood sugar, rash or other skin changes, nausea, vomiting, mouth sores, tiredness, reduced appetite, lower white blood cell counts, and anemia. Your care team will keep an eye on your blood sugar and blood counts throughout treatment and can adjust or pause your dose if things get uncomfortable.
Two things are worth flagging specifically. Blood sugar and ketoacidosis: Truqap can raise blood sugar, sometimes significantly, even if you've never had diabetes — left unchecked, this can turn into a serious condition needing hospital care, so blood sugar checks before and during treatment really do matter. Diarrhea and skin reactions: these can occasionally become severe enough to cause dehydration or need medical attention, so don't wait it out quietly — tell your doctor as soon as either shows up.
If you're pregnant or could become pregnant: Truqap can harm a developing baby, so effective non-hormonal contraception is needed during treatment and for one month after your last dose (four months for male partners). This is one conversation worth having with your doctor before you start.
The same AKT pathway that drives this breast cancer subtype also shows up in certain prostate cancers. In 2026, the FDA approved Truqap alongside abiraterone and prednisone for men with PTEN-deficient, metastatic hormone-sensitive prostate cancer — the first targeted option built specifically for that harder-to-treat group.
If your test results make you a candidate for Truqap, finding out it isn't sold in India yet can feel like a setback right when you don't need one more. The good news is it can still be legally imported for your personal treatment through a Named Patient Program — a regulated route that lets a patient with a valid prescription bring in a medicine that isn't locally available yet. In practice, this usually means:
The Truqap product page walks through the process in more detail, and our oncology access program supports the same pathway for other targeted medicines, including Kisqali and Orserdu for other biomarker-driven breast cancers.
No two patients' reports look exactly alike, so honestly, the quickest way to get a real answer for your situation is to just ask someone. Send us your reports or a quick message about where you are in the process, and our team will walk you through what's possible — prescription, paperwork, timelines, all of it — with no pressure and no obligation. Get in touch with us whenever you're ready.
Hearing "advanced" or "metastatic" attached to your diagnosis is genuinely hard, and it's okay to feel that. But it's also true that this specific area of treatment has moved forward fast — biomarker testing now routinely opens doors that didn't exist a few years ago, and combinations like capivasertib with fulvestrant have given many patients meaningfully more time before their disease progresses again. It's worth re-testing even if an earlier result was negative, since tumors can pick up new mutations as they adapt to treatment over time.
What does HR-positive, HER2-negative breast cancer actually mean? Your cancer cells grow using estrogen and/or progesterone as fuel, but they don't overproduce the HER2 protein. It's the most common form of breast cancer, and it generally responds well to hormone-blocking treatment, at least at first.
What are PIK3CA, AKT1 and PTEN, and why do they matter to me? They're genes on the same growth-signaling pathway inside your tumor. A mutation in any one of them can keep cancer growing even while hormone therapy is working against it. Testing for them tells your doctor whether a targeted option like Truqap could help you.
Is Truqap chemotherapy? No — it's a targeted oral therapy that blocks one specific protein (AKT) involved in tumor growth, not a drug that broadly attacks all fast-dividing cells the way chemotherapy does.
Can this cancer come back after treatment works? Yes, sometimes months or years later, and sometimes with new mutations that weren't there the first time — which is why doctors often retest at the point of recurrence rather than assuming nothing has changed.
Does everyone with this diagnosis need Truqap? No. It's specifically for people whose tumor tests positive for a PIK3CA, AKT1 or PTEN change and who've already progressed on hormone-based treatment. Most people follow a different, earlier-line treatment path.
Where can I get Truqap if it isn't sold where I live? Through a regulated Named Patient Program, which lets a specific, named patient import the medicine with a valid prescription, biomarker results, and the right documentation — a legal route used around the world for medicines that aren't locally available yet.
Is it safe to order Truqap from an online pharmacy that offers it at a lower price? A lower price is often the first warning sign. Counterfeit and substandard cancer medicines are sold through unregulated online sellers, and they can look identical to the real product — leaving you with no way to know the true ingredient, dose, or storage history. Named Patient Program avoids this by importing only against a valid prescription, straight from the manufacturer or its authorized distributors, with documentation and batch traceability at every step. That is the difference between a medicine that is verified and one that is only claimed to be genuine.
This article is for general educational purposes and does not replace medical advice. Please consult a qualified oncologist for diagnosis and treatment decisions specific to your case.
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