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For patients with prior HR+HER2- localized breast cancer currently receiving adjuvant endocrine therapy, is there a time period in which you would no longer recommend adding adjuvant abemaciclib?

(Assuming they meet MonarchE criteria) For example, if the patient is in year 2, 3, 4, or 5 of adjuvant endocrine therapy versus 9 months out, would this change your recommendation?
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What is the longest period of time from definitive breast cancer surgery that you would recommend a patient could start adjuvant abemaciclib?

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3 Answers
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Medical Oncology · H Lee Moffitt Cancer Center, University of South Florida
Answered on

This is a great question and I hope we eventually have data to guide us. I also do not know how insurers will handle these types of requests. This high-risk ER+ population has a 10-year risk of distant recurrence between 20 to 40% with continued risk of recurrence over 20 years based on the EBCTCG d...

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Medical Oncology · University of Texas MD Anderson Cancer Center
Answered on

The benefit of adjuvant abemaciclib shown in the monarchE trial was in fact, recently updated (Johnston et al., PMID 41110697) and is showing a sustained reduction in recurrence risk (HR 0.664) compared to HR 0.75 in the initial analysis.

However, the question of delayed therapy and whether the impac...

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Medical Oncology · The Center for Hematology and Oncology at Holy Cross Hospital
Answered on

There is no prospective data on using it over 2 years. I am comfortable recommending it for up to 2 years.

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