The dilemma of selecting a first line CDK4/6 inhibitor for hormone receptor-positive/HER2-negative metastatic breast cancer

Albert Grinshpun; Sara M Tolaney; Harold J Burstein; Rinath Jeselsohn; Erica L Mayer

doi:10.1038/s41523-023-00520-7

The dilemma of selecting a first line CDK4/6 inhibitor for hormone receptor-positive/HER2-negative metastatic breast cancer

NPJ Breast Cancer. 2023 Mar 22;9(1):15. doi: 10.1038/s41523-023-00520-7.

Authors

Albert Grinshpun^{1

2

3}, Sara M Tolaney^{1

2

3}, Harold J Burstein^{1

2

3}, Rinath Jeselsohn^{1

2

3}, Erica L Mayer^{4

5

6}

Affiliations

¹ Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
² Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
³ Harvard Medical School, Boston, MA, USA.
⁴ Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. erica_mayer@dfci.harvard.edu.
⁵ Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA. erica_mayer@dfci.harvard.edu.
⁶ Harvard Medical School, Boston, MA, USA. erica_mayer@dfci.harvard.edu.

Abstract

The combination of an endocrine agent with a CDK4/6 inhibitor is the standard of care in the first-line setting for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Randomized trials have demonstrated similar and significant improvements in progression-free survival using the three available CDK4/6 inhibitors and led to regulatory approval. However, mature overall survival data now suggest potential differences among the various agents, suggesting an evolution in selection preferences.