Dr. Hamilton on the Utility of CDK4/6 Inhibitors in HR+/HER2- Breast Cancer

Erika P. Hamilton, MD, director, Breast Cancer and Gynecologic Cancer Research Program, principal investigator, Sarah Cannon Research Institute, discusses the utility of CDK4/6 inhibitors in hormone receptor (HR)–positive, HER2-negative breast cancer.

It is important to determine which patients are most likely to benefit from different treatments in HR-positive breast cancer, Hamilton says. At the 2021 ESMO Congress, updated data from the phase 3 MONALEESA-2 trial (NCT01958021) were presented, demonstrating an encouraging improvement in overall survival with the CDK4/6 inhibitor ribociclib (Kisqali) plus letrozole vs placebo plus letrozole in postmenopausal women with HR-positive, HER2-negative recurrent or metastatic breast cancer , Hamilton adds. 

Overall, these data are practice affirming and indicate that postmenopausal patients with HR-positive, HER2-negative disease should be offered CDK4/6 inhibitors in the frontline setting, Hamilton continues. Beyond CDK4/6 inhibitors, further treatment refinement is needed to optimize options for patients with PIK3CA or ESR1 alterations. Novel oral selective estrogen receptor degraders are emerging as a potential strategy for these patients; however, it is important to continue parsing out what treatments are best suited for individual patients, Hamilton concludes.