Two Onc Docs Metastatic Breast Cancer 2025 UPDATE
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Oct 20, 2025 Delve into cutting-edge advancements in metastatic breast cancer treatment. Frontline options for ER/PR-positive patients and the intricacies of CDK4/6 inhibitors are discussed. Key insights on HER2-positive regimens reveal exciting trial data. Triple-negative challenges are tackled with biomarker testing and promising therapies. Learn about the role of bone protective agents in care strategies. The hosts wrap up with practical treatment algorithms and reminders for optimal patient management.
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Frontline ER/PR Strategy
- For frontline ER/PR-positive metastatic breast cancer, give an AI or fulvestrant plus a CDK4/6 inhibitor.
- For BRCA1/2-positive patients start a PARP inhibitor up front and consider ovarian suppression in premenopausal women.
CDK4/6 Monitoring Essentials
- Monitor CBCs and LFTs routinely with CDK4/6 inhibitors and watch for fatigue and pneumonitis.
- Get a baseline EKG for ribociclib and expect more neutropenia with palbociclib.
Key CDK4/6 Differences
- Only ribociclib has shown a significant overall survival benefit among CDK4/6 inhibitors.
- RB1 mutation or loss confers resistance to this drug class and is testable.