Articles related to ENDOCRINE THERAPY

A phase II trial showed a significant progression-free survival benefit when patients with HR+/HER2- metastatic breast cancer switched endocrine therapy and received ribociclib, indicating the potential of this treatment strategy for those who progress on endocrine therapy and palbociclib. Learn more about the findings and implications for clinical practice.

This study analyzed 147 patients with hormone receptor-positive and HER2-positive metastatic breast cancer (HR+/HER2+ MBC) who received first-line chemotherapy and dual anti-HER2 therapy using a real-world registry dataset. The efficacy of adding endocrine therapy to dual anti-HER2 therapy after chemotherapy discontinuation was studied retrospectively. The researchers discovered that endocrine therapy resulted in statistically significant and clinically meaningful improvements in both PFS and overall survival outcomes. In the first-line treatment of HR+/HER2+ MBC, the current standard practice is to administer a CLEOPATRA trial-based regimen that includes taxane, pertuzumab, and trastuzumab until the best response is achieved and then discontinue chemotherapy. These findings, with a hazard ratio of 0.52 for overall survival with the addition of endocrine therapy, confirm that all patients with HR+/HER2+ MBC should receive endocrine therapy after achieving the best response with chemotherapy.

A literature review involving 24 recent studies yielded an update to ASCO’s recommendations on appropriate use of breast cancer biomarker assay results to guide adjuvant endocrine and chemotherapy decisions in early-stage breast cancer.

According to the final results from the phase 3 PALLAS trial, palbociclib offers no benefit over endocrine therapy alone in women with early HR+ HER2- breast cancer. The primary endpoint — 4-year invasive DFS — was nearly equivalent in the test and control arms of the study. None of the secondary endpoints showed a significant difference either. There was a high rate of palbociclib discontinuation (42%), mostly due to grade 3 or 4 neutropenia. But even in those who completed the two-year planned course showed no benefit over endocrine therapy alone. The results were not just disappointing, but surprising given that CDK 4/6 inhibitors plus endocrine therapy is the standard of care for advanced breast cancer.