Itovebi (Inavolisib)

Itovebi is a PI3Kα‑selective inhibitor used in oncology to address malignancies driven by the PI3K/AKT/mTOR pathway.

• Advanced solid tumours: helps control disease progression in patients with PI3K‑driven cancers.
• Hormone‑receptor‑positive breast cancer: used in combination regimens to improve outcomes.
• PI3K pathway‑mutated cancers: targets tumours with specific genetic alterations in the PI3Kα isoform.

• Inavolisib selectively binds to the catalytic pocket of the PI3Kα isoform, inhibiting its kinase activity. This blockade prevents downstream phosphorylation of AKT and mTOR, disrupting cellular proliferation, survival, and metabolic signaling pathways that are frequently up‑regulated in malignant cells, thereby exerting antineoplastic effects.

Adverse reactions may occur with any antineoplastic therapy and should be monitored by the treating clinician.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: increased stool frequency.
• Fatigue: reduced energy levels.
• Rash: skin irritation or erythema.
• Elevated liver enzymes: mild hepatic enzyme changes.
• Hyperglycaemia: increased blood glucose levels.

Serious or Rare Side Effects

• Severe neutropenia: marked reduction in white blood cells.
• Interstitial lung disease: inflammatory lung condition.
• Severe hepatic dysfunction: significant liver injury.
• Thromboembolic events: blood clot formation.
• Severe hyperglycaemia: uncontrolled high blood sugar.
• Life‑threatening allergic reactions: anaphylaxis.

Patients receiving Itovebi should be evaluated for potential risks and monitored throughout therapy.

• Baseline labs: obtain complete blood count, liver function tests, and fasting glucose before starting treatment.
• Monitor glucose: regularly check blood sugar, especially in diabetic patients.
• Liver function: assess hepatic enzymes periodically during therapy.
• Infection risk: watch for signs of infection due to possible neutropenia.
• Pregnancy and lactation: avoid use unless benefits clearly outweigh potential risks.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Inavolisib may interact with other medicines that affect the same metabolic pathways or increase toxicity.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may raise Inavolisib plasma levels.
• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce therapeutic exposure.

Moderate Interactions (Monitor Closely)

• Antidiabetic agents: risk of enhanced hyperglycaemia.
• Other PI3K/AKT/mTOR inhibitors: additive toxicity.
• Anticoagulants: potential for increased bleeding risk.