Questions From the Clinic on the Management of HR-Positive, HER2-Negative Early Breast Cancer: A Quickfire Countdown Authors: Kevin Kalinsky, MD; Giuseppe Curigliano, MD, PhD

https://www.medscape.org/viewarticle/1002378?sso=true&uac=148436CN&src=mkmcmr_reeng_recap_mscpedu_activity Questions From the Clinic on the Management of HR-Positive, HER2-Negative Early Breast Cancer: A Quickfire Countdown Below are some key learning points to help reinforce the impact of this activity. ☑ Clinical trials, including monarchE and NATALEE, have demonstrated that patients with hormone receptor (HR)-positive, HER2-negative early breast cancer and higher genomic risk scores derive significant benefit from cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors in the adjuvant setting. ☑ In cases where chemotherapy is not indicated and there is discordance between clinical stage and genomic assay results, consider adding a CDK 4/6 inhibitor therapy if the patient meets the eligibility criteria. ☑ While no definitive data exist regarding switching between CDK 4/6 inhibitors in the adjuvant setting, experts find it appropriate if the patient is not able to tolerate the initial treatment. ☑ In a patient with early-stage, HR-positive, HER2-negative breast cancer who meets both the monarchE criteria for the use of abemaciclib and the NATALEE criteria for the use of ribociclib, several factors should be considered: • Maturity of clinical data in the adjuvant setting • Duration of treatment • Patient tolerability ☑ Dose reduction has proven to be an effective approach for managing adverse events without compromising the efficacy of treatment.