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Abstract
Several therapeutic options are available for management of premenopausal patients with metastatic hormone-receptor-positive breast cancer, including single-agent endocrine therapy or combination regimens. Single agent treatment with an aromatase inhibitor or tamoxifen has resulted in major improvements in the adjuvant setting but has shown little clinical benefit in metastatic disease. 1 Bonneterre J Thürlimann B Robertson JF et al. Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: results of the Tamoxifen or Arimidex Randomized Group Efficacy and Tolerability study. J Clin Oncol. 2000; 18: 3748-3757 Crossref PubMed Scopus (792) Google Scholar , 2 Mauri D Pavlidis N Polyzos NP Ioannidis JP Survival with aromatase inhibitors and inactivators versus standard hormonal therapy in advanced breast cancer: meta-analysis. J Natl Cancer Inst. 2006; 98: 1285-1291 Crossref PubMed Scopus (228) Google Scholar Endocrine therapy is the standard of care for hormone-receptor-positive luminal, HER2-negative metastatic breast cancer. However, resistance to endocrine treatment remains a major clinical problem, especially for patients with metastatic disease. Therefore management of resistance to endocrine therapy is an active area of research. 3 Johnston SR New strategies in estrogen receptor-positive breast cancer. Clin Cancer Res. 2010; 16: 1979-1987 Crossref PubMed Scopus (171) Google Scholar Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trialFulvestrant plus palbociclib was associated with significant and consistent improvement in progression-free survival compared with fulvestrant plus placebo, irrespective of the degree of endocrine resistance, hormone-receptor expression level, and PIK3CA mutational status. The combination could be considered as a therapeutic option for patients with recurrent hormone-receptor-positive, HER2-negative metastatic breast cancer that has progressed on previous endocrine therapy. Full-Text PDF
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