Fast Five Quiz: HR-Positive/HER2-Negative Breast Cancer

Winston W. Tan, MD; Stefania Morganti, MD


June 28, 2023

Preferred first-line systemic endocrine-based therapy options per National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) guidelines include an aromatase inhibitor (anastrozole, exemestane, or letrozole) in combination with a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor (palbociclib, ribociclib, or abemaciclib) or fulvestrant in combination with a CDK4/6 inhibitor.

Preferred second-line systemic endocrine-based therapy options include fulvestrant in combination with a CDK4/6 inhibitor (if a CDK4/6 inhibitor was not utilized in the first-line setting), fulvestrant in combination with alpelisib (only in patients with PIK3CA mutations), or everolimus combined with endocrine therapy (exemestane, fulvestrant, tamoxifen).

Anti-HER2 targeted therapies, with or without chemotherapy, are used only for HER2+ breast cancer. Many studies have shown that these treatments dramatically improve survival of patients with HER2+ breast cancer.

Learn more about medications for metastatic breast cancer.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.