Optimal First-Line Treatment of HR+/HER2- Advanced/Metastatic Breast Cancer

Giuseppe Curigliano, MD, PhD


June 08, 2023

For a long time, the backbone of treatment for hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2-) breast cancer was endocrine therapy.

In recent years, however, it has been shown that for patients with advanced or metastatic disease, the addition of a cyclin-dependent kinase (CDK)4/6 inhibitor in the first-line setting significantly improves progression-free and overall survival.

Prof Giuseppe Curigliano, clinical director of the European Institute of Oncology in Milan, Italy, examines the essential considerations when choosing the first-line therapy. He says that the data support a combination of endocrine therapy plus CDK4/6 inhibition as optimal, and reports that the endocrine partner depends on whether the breast cancer is endocrine sensitive or resistant.

He emphasizes the importance of estimating the magnitude of clinical benefit as well as the need for shared decision-making with the patient, including a discussion of possible toxicities.


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