Subscribe Today!

To sign up for our newsletter or print publications, please enter your contact information below.

I'd like to receive:

Updates on Endocrine Therapy for Metastatic Breast Cancer

2021 Year in Review - Breast Cancer - Breast Cancer

Endocrine therapy is the backbone of treatment for patients with hormone receptor (HR)-positive, HER2-negative, metastatic breast cancer. The introduction of novel endocrine medication combinations as a result of tumor resistance to hormone therapy has changed the landscape of metastatic breast cancer care. The possibilities of endocrine therapy are growing, with promising agents on the horizon. Despite the fact that metastatic breast cancer is incurable, many people can live for years with a good quality of life by cycling through the various treatments available. Because of the large number of available agents and the speed with which they are approved, physicians rely on evidence-based guidelines to help them choose the best treatment for their patients.1

Combining endocrine therapy with cyclin-dependent kinase (CDK)4/6 inhibitors is one of the most successful combinations, both as initial therapy and after progression on endocrine therapy. These combinations enhanced progression-free survival and objective response rates in patients with HR-positive advanced breast cancer.2 Patients with HR-positive, HER2-negative, metastatic breast cancer had a median survival of 16 to 26 months prior to the development of CDK4/6 inhibitors. CDK4/6 inhibitors have significantly altered the landscape of metastatic breast cancer, resulting in unprecedented improvements in progression-free survival and overall survival.1

In addition to CDK4/6 inhibitors, research has enhanced our understanding of advanced breast cancer biology, resulting in the identification of additional targets to complement endocrine therapy. These include mTOR inhibitors, histone deacetylase inhibitors, and phosphoinositide 3-kinase inhibitors. The fast development and approval of new therapies might make it difficult to determine which treatment option is optimal for a patient. Physicians will need to rely on evidence-based guidelines in their clinical practice.1

Given the intricacy of these medications, identifying patient and tumor features that can assist with when and in which patients to use CDK4/6 inhibitors in the therapy paradigm is a hot topic. To date, a number of CDK4/6 inhibitor trials have shown that adding a CDK4/6 inhibitor to endocrine therapy improves treatment outcomes across all patient subgroups.3 Alternative treatment techniques should be given special consideration for elderly patients and those with baseline neutropenia or poor performance status. The capacity to undertake next-generation sequencing has transformed the metastatic breast cancer paradigm.1 Patients with HR-positive, HER2-negative, metastatic breast cancer should have new hope as research into combining endocrine therapies with newer targeted medicines and immunotherapy continues.1


  1. Manohar PM, Davidson NE. Updates in endocrine therapy for metastatic breast cancer. Cancer Biol Med. 2021 Oct 5. Epub ahead of print.
  2. Di Leo A, O’Shaughnessy J, Sledge Jr GW, et al. Prognostic characteristics in hormone receptor-positive advanced breast cancer and characterization of abemaciclib efficacy. NPJ Breast Cancer. 2018;4:41.
  3. Andrahennadi S, Sami A, Manna M, et al. Current landscape of targeted therapy in hormone receptor-positive and HER2-negative breast cancer. Curr Oncol. 2021;28:1803-1822.
Related Items
Enhertu Received Regular FDA Approval for Patients with Unresectable or Metastatic Breast Cancer
JHOP - June 2022 Vol 12, No 3 published on June 16, 2022 in FDA Oncology Update, Breast Cancer
Pembrolizumab plus Chemotherapy for Neoadjuvant and Adjuvant Therapy in Early Triple-Negative Breast Cancer: KEYNOTE-522
Robert J. Ignoffo, PharmD, FASHP, FCSHP, FHOPA
JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in From the Literature, Breast Cancer, Checkpoint Inhibitors
Lynparza Receives FDA Approval for Adjuvant Treatment of High-Risk Early Breast Cancer with BRCA Mutation
JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in FDA Oncology Update, Breast Cancer
Evaluating Adverse Events in Patients with Breast Cancer and HIV Infection Receiving Concomitant Antiretroviral Therapy and Chemotherapy with Curative Intent
Donyika Joseph, PharmD, BCOP, Farnaz Foolad, PharmD, BCPS, Neelam K. Patel, PharmD, BCOP, Meghan Karuturi, MD, MSc, Jaime Kaushik, PharmD, BCOP
JHOP - April 2022 Vol 12, No 2 published on May 2, 2022 in Original Article, Adverse Events, Breast Cancer, Infections
Advances in Breast Cancer Treatments: Are We Extending Patients’ Survival?
Meg Barbor, MPH
JHOP - June 2019 Vol 9, No 2 published on April 28, 2022 in HOPA Highlights, Breast Cancer
Development and Implementation of a Pharmacist-Led Virtual Clinic Improve the Management of Patients with Metastatic Breast Cancer Receiving CDK4/6 Inhibitors
JHOP - March 2022 Vol 12 Special Feature published on March 22, 2022 in HOPA Abstracts, Breast Cancer
Time to Treatment Initiation and Outcomes for Patients with Nonmetastatic Breast Cancer Before and During the COVID-19 Pandemic at Community Cancer Centers
JHOP - March 2022 Vol 12 Special Feature published on March 22, 2022 in HOPA Abstracts, Breast Cancer
Spontaneous Tumor Lysis Syndrome in a Patient with Stage IV HER2-Positive Breast Cancer: Case Report
Blake T. Robbins, PharmD, MBA , Alexander M. Kreimer, PharmD, BCPS , Reema A. Patel, MD, Allison R. Butts, PharmD, BCOP
JHOP - February 2022 Vol 12, No 1 published on March 1, 2022 in Case Reports, Tumor Lysis Syndrome, Breast Cancer
Sacituzumab Govitecan Moves to Second-Line Therapy for Metastatic Triple-Negative Breast Cancer: Applying the Lessons from Clinical Trials to Clinical Practice
February 2022 Clinical Trials to Clinical Practice published on February 3, 2022 in Clinical Trials, Breast Cancer
A Subanalysis of the Phase 3 MONARCH 3 Study of Abemaciclib as Initial Therapy for HR-Positive, HER2-Negative Advanced Breast Cancer
2021 Year in Review - Breast Cancer published on January 21, 2022 in Breast Cancer
© Amplity Health. All rights reserved.