How do the findings from the INAVO120 trial influence your decision-making process for selecting subsequent lines of therapy in patients who have relapsed after adjuvant CDK4/6 inhibition?  

The earlier deployment of CDK4/6 inhibitors has the potential to influence the clinical patterns of subsequent disease progression and the underlying genomic landscape of resistance. We are continuing to strive toward delivering personalized therapy based upon each patient's unique molecular genomic...

The results of INAVO120 have not influenced my recommendations for subsequent lines. If a patient has had first-line CDK4/6i with endocrine therapy for metastatic breast cancer, at the time of progression, I review genomic testing, including ctDNA or biopsy testing for ESR1 at the time of progressio...

Great question. We are already challenged in choosing subsequent lines of therapy for hormone receptor-positive MBC. Most of the randomized trials for metastatic breast cancer include 1st and 2nd line therapy. Very few allow 3rd line or later therapy. So, we have to pick and choose 1st lin...

Would you still use the INAVO regimen for patients who relapse with P13K-mutated metastatic breast cancer on or shortly after use of adjuvant CDK4/6i? At first, one is tempted to say no; however, if you review the data, the answer can be yes. Here is the rationale, as well as the data:PIK3CA mutatio...

The INAVO120 trial opens the door to considering whether multiple targeted therapies with an endocrine backbone may be better than one targeted therapy in high-risk patients. At this time, we don't have enough evidence to do this routinely for patients after progression on CDK4/6i, and more research...

I would consider using the INAVO regimen (including palbociclib) in these patients. Multiple factors influence this decision:- Data from MAINTAIN (and prior retrospective data) showing benefit with continued CDK4/6 inhibition after progression on a regimen including a CDK4/6 inhibitor. None of the d...