2020 Year in Review - Breast Cancer

Primary analysis of a multicenter, randomized clinical trial suggests that endocrine therapy demonstrates benefits over capecitabine when used as a maintenance therapy after first-line combination chemotherapy in hormone receptor–positive, HER2-negative advanced metastatic breast cancer.
This real-world study of patients with hormone receptor–positive, HER2-negative advanced breast cancer treated with a palbociclib-based therapy as either first- or second-line therapy, showed similar safety and efficacy when compared with clinical study results.
During the COVID-19 pandemic, there was a decline in the number of patients beginning first-line treatment. There was a decrease in the percentage of patients receiving CDK4/6 inhibitor combination therapy while a simultaneous increase in endocrine monotherapy was observed.
In a large, diverse cohort of patients, this analysis confirms the safety and efficacy of ribociclib plus letrozole with data that are consistent with those observed in the MONALEESA trials, supporting the use of this combination in the first-line setting.
When combined with fulvestrant, alpelisib produced clinically and statistically relevant progression-free survival despite the baseline poorer prognosis in patients with hormone receptor–positive, HER2-negative, PIK3CA mutation–positive advanced breast cancer.
Patients and oncologists are prepared to make trade-offs between efficacy and toxicities, but patients appreciate toxicities impacting quality of life while endeavoring to increase survival.
In patients with metastatic hormone receptor–positive breast cancer treated previously with a CDK4/6 inhibitor, there was a lower median progression-free survival benefit from everolimus in combination with exemestane compared with those patients who had not received this combination.
In this study, a high rate of radiation toxicity was observed in patients with advanced breast cancer treated with CDK4/6 inhibitors.
Updated phase 2 study results of lerociclib (G1T38) combined with fulvestrant support continuous dosing without a drug holiday.
In the MONARCH plus study, the majority of abemaciclib-associated diarrhea events were low grade in severity and well managed by antidiarrheal medications, dose omissions, and/or dose reductions.
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