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Would you consider AI alone over CDK4/6 inhibitor combinations in older patients with breast cancer considering the subgroup analyses from MONALEESA-2 suggest less benefit in patients over 65?

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Mednet Member
Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty

In MONALEESA-2, 295 patients (44%) were ≥ 65 years of age, 150 were randomized to ribociclib + letrozole; and 145 received placebo + letrozole. 370 patients were <65 years of age, 184 were randomized to the ribociclib group, and 186 to the placebo group. The baseline characteristics were balanced be...

Do the results of S0226 change your endocrine therapy of choice in denovo metastatic hormone positive breast cancer?

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3 Answers

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Mednet Member
Medical Oncology · Private Practice and Digital Health

S0226 compared anastrozole to anastrozole plus fulvestrant loading dose in first-line treatment of metastatic ER-Positive Breast Cancer. The combination arm was more effective than anastrozole alone, with a significant improvement in PFS and OS. This concept of complete ER blockade has been an attra...

How will the final overal survival results of PALOMA-3 affect your practice?

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1 Answers

Mednet Member
Mednet Member
Medical Oncology · Private Practice and Digital Health

I will generally give a trial of first line endocrine therapy with an AI if endocrine-sensitive disease, and reserve Paloma-3 regimen to second line. Endocrine sensitivity can be inferred clinically by disease course (late relapse, recurrence off adjuvant endocrine therapy, asymptomatic status/or mi...