Abstract
SummaryRecent findings support the role of alpelisib in advanced HR-positive breast cancer harboring a PIK3CA mutation. A retrospective biomarker analysis on the intrinsic subtypes of HR-positive breast cancer reveals a subgroup that will not benefit under the addition of a CDK 4/6 inhibitor treatment. The detection of circulating tumor cells before start and during tumor treatment is associated with worse outcome in metastatic breast cancer patients.
Highlights
The treatment of hormone-receptor (HR)-positive, HER2-negative metastatic breast cancer has changed over the past years and is an emerging field
The phase 3 MONALEESA-2, -3 and -7 trials investigated the addition of the cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor ribociclib to endocrine therapy versus endocrine therapy alone and led to a significant prolonged progression-free survival (PFS) [4,5,6]
Patients with luminal A tumors had a median PFS of 19.48 months in the placebo arm and 29.8 (23.03–not available [NA]) months in the ribociclib arm
Summary
After approval in the SOLAR-1 trial the phosphoinositide 3-kinase (PI3K) inhibitor alpelisib in combination with fulvestrant became a new treatment option in metastatic HR-positive breast cancer [1]. There was only a small number of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor pretreated patients in this study leading to the need of more studies investigating its role in this setting. The phase II BYLieve trial is a prospective trial enrolling 336 patients with HRpositive, HER2-negative, PIK3CA-mutated metastatic
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