Abstract BACKGROUND: PI3K/AKT/mTOR inhibitors represent a significant therapeutic advance for HR-positive, HER2-negative advanced breast cancer (ABC). However, real-world adoption in community settings remains limited. To understand clinician perceptions and challenges associated with managing treatment-related toxicities, a multi-phase CME initiative was developed to gather insights directly from community practitioners and deliver targeted education focused on adverse event (AE) management. METHODS: Phase 1 of the initiative consisted of a 90-minute virtual roundtable discussion featuring two academic and four community-based breast oncologists. Discussion topics included real-world barriers, specialist coordination, and strategies to individualize care. Qualitative analysis of the roundtable transcript was conducted to identify thematic insights and consensus strategies. These findings were synthesized and served as the foundation for phase two. Phase 2 was a 45-minute accredited activity focused on clinical evidence, AE mitigation, and patient-centered treatment planning. The content integrated roundtable-derived consensus and aligned with published evidence and guidelines on managing AEs in HR+/HER2- ABC. The activity launched on Medlive.com in October 2024 and will remain available for 1 year. Program outcomes were measured through pre-/post-activity assessments and post-activity evaluations. Results: During the roundtable discussion (n=6), panelists identified hyperglycemia, rash, and diarrhea as the most challenging AEs associated with PI3K/AKT/mTOR inhibitor therapy. Hyperglycemia was rated by 100% of participants as the most difficult to manage, particularly in community settings where limited access to endocrinology was cited as a key barrier. Rash was identified by 83% of panelists as a common and distressing AE that frequently required dose interruption or discontinuation. Diarrhea was considered less severe but still impactful, with all panelists noting that early patient education and symptom recognition were essential to prevent treatment disruption. There was panel-wide consensus on the importance of multidisciplinary coordination to manage AEs effectively. However, 75% of the community-based panelists noted that limited access to dermatology, endocrinology, and/or pharmacy support often prevents optimal implementation of proven management strategies. Following the roundtable, 10,240 clinicians engaged with the education. Among CME participants, 83% completed the activity. Post-activity, 45% anticipated increased coordination with specialists to address toxicities, 34% reported greater intent to use PI3K/AKT/PTEN-pathway inhibitors in biomarker-selected patients, and 33% planned to adopt more rigorous biomarker testing protocols. Significant knowledge gains (p.05) were observed in understanding of molecular mechanisms (+29%) and interpretation of key efficacy data from pivotal trials (+27%). Conclusions: The roundtable revealed critical barriers to integrating pathway-directed therapies in community settings, including gaps in specialist access, variability in supportive care infrastructure, and uncertainty around AE management. The educational component demonstrated measurable improvements in knowledge and intent to change practice, supporting the value of combining qualitative insights with structured learning to address implementation challenges. When grounded in real-world perspectives and reinforced by clinical data, education on targeted therapies can enhance clinician readiness to integrate these strategies into routine care and overcome barriers in community settings. Supported by an independent medical education grant from AstraZeneca. Citation Format: K. Jones, T. Ackbarali, K. Jhaveri, T. Traina. Pi3k/akt/mtor inhibitors in hr+/her2- breast cancer: bridging the gap between evidence and community practice in toxicity management abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-12-23.
Jones et al. (Tue,) studied this question.