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?
Answer from: Medical Oncologist at Academic Institution
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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Answer from: Medical Oncologist at Academic Institution
The benefit of adjuvant abemaciclib shown in the monarchE trial was in fact, recently updated (Johnston et al., PMID 36493792) 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...
Answer from: Medical Oncologist at Community Practice
There is no prospective data on using it over 2 years. I am comfortable recommending it for up to 2 years.