Frontline Treatment for Advanced HR+/HER2- Breast Cancer

Kevin Kalinsky, MD


March 27, 2023

Endocrine therapy (ET) has long been the therapeutic backbone for the treatment of HR+/HER2- breast cancer. However, for patients who already have advanced HR+/HER2- disease at the time of diagnosis, studies have shown that addition of a CDK4/6 inhibitor significantly improves outcomes compared with ET alone.

In this ReCAP, Dr Kevin Kalinsky, director of the Glenn Family Breast Center at Winship Cancer Institute in Atlanta, Georgia, examines important considerations in the frontline treatment of HR+/HER2- advanced breast cancer.

First, he reviews the PALOMA-2 data, which looked at the overall survival of the CDK4/6 inhibitor palbociclib plus letrozole. He then compares that data with the overall survival data of other CDK4/5 inhibitors.

Dr Kalinsky then examines the findings of MONALEESA-7, which looked at premenopausal patients with HR+/HER2- advanced breast cancer treated with ET plus or minus ribociclib. In that study population, the combination of ET and ribociclib showed an overall survival advantage.

Finally, he discusses data from the Right Choice trial, which found that patients did better when given hormonal therapy plus a CDK4/6 inhibitor as opposed to doublet chemotherapy.


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