Optimizing Tx of HRpos HER2neg MBC

CME

Optimizing Treatment for Patients With HR-Positive/HER2-Negative MBC

Physicians: Maximum of 0.50 AMA PRA Category 1 Credit

Released: March 24, 2025

Expiration: September 23, 2025

Activity

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Introduction

In this module, Sara A. Hurvitz, MD, FACP reviews the current treatment algorithm, guidelines, and evidence-based approaches for the optimal integration of CDK4/6 inhibitors into the holistic care of patients with hormone receptor (HR)-positive/HER2-negative metastatic breast cancer (MBC) with careful consideration of patients’ preexisting comorbidities, concomitant medications, and goals of care.

The key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slideset, which can be found here or downloaded by clicking any of the slide thumbnails alongside the expert commentary.

Clinical Care Options plans to measure the educational impact of this activity. A few questions will be asked twice: once at the beginning of the activity and then again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions

How many people with breast cancer do you provide care for in a typical month?

A 63-year-old woman presents with estrogen receptor (ER)–positive/progesterone receptor (PR)–negative HER2 (immunohistochemistry [IHC] 1+) MBC involving the liver and lungs 6 months after starting adjuvant anastrozole for stage IIIA left-sided breast cancer. Genetic testing is negative for germline BRCA mutations. Next-generation sequencing (NGS) testing revealed both a PIK3CA mutation and an ESR1 mutation. Her medical history includes mild hypertension treated with hydrochlorothiazide. She has obesity but is very active. Her Eastern Cooperative Oncology Group (ECOG) performance status (PS) is 0. She has a baseline fasting plasma glucose of 110 mg/dL and glycated hemoglobin (HbA1C) of 5.6%.

Which of the following regimens would you choose as the optimal first-line treatment for this patient?