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.
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Cite this: Winston W. Tan, Stefania Morganti. Fast Five Quiz: HR-Positive/HER2-Negative Breast Cancer - Medscape - Jun 28, 2023.