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Optimizing care for younger women with hormone receptor‐positive, HER2‐negative metastatic breast cancer
Author(s) -
Boer Richard,
Hui Rina,
Lim Elgene,
Yeo Belinda,
Zdenkowski Nicholas
Publication year - 2020
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.13461
Subject(s) - metastatic breast cancer , medicine , breast cancer , oncology , cancer , hormone receptor , endocrine system , clinical trial , hormone , gynecology
Treatment strategies for hormone receptor‐positive (HR + ), human epidermal growth factor receptor 2‐negative (HER2 – ) metastatic breast cancer in young women (<40 years at diagnosis) have traditionally been extrapolated from data obtained from trials conducted either exclusively or predominantly in the postmenopausal setting. These young patients are usually treated with ovarian function suppression (OFS) + endocrine therapy (ET) ± targeted therapy, except if there is a concern about endocrine resistance or a need to gain rapid disease control due to the onset of visceral crisis. This review examines evidence that supports the use of a cyclin‐dependent kinase 4/6 inhibitor, in combination with OFS and ET, when treating premenopausal or perimenopausal women with HR + /HER2 – metastatic breast cancer. This includes data from the MONALEESA‐7 study (treating only premenopausal/perimenopausal women in the first‐line setting), and the results of subgroup analyses from the PALOMA‐3 and MONARCH‐2 trials. We also consider a number of age‐specific challenges that younger breast cancer patients can face, highlighting the importance of a multidisciplinary approach to ongoing care.