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?
Answer from: Medical Oncologist at Community Practice
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 characterist...
Sign in or Register to read more
Answer from: Medical Oncologist at Community Practice
There are several factors to take into consideration when balancing the merits of treatment in older patients with metastatic ER-positive breast cancer.First, we do know that disease characteristics and ER biology change with age, and older patients tend to have more ER-dependent tumors and more fav...
Comments
Medical Oncologist at Florida Cancer Specialists
Since only a small fraction of the control patient...
Since only a small fraction of the control patient...
Medical Oncologist at Valley Med Onc
Dr. @Rubin brings up a very important point. We ar...
Dr. @Rubin brings up a very important point. We ar...
Answer from: Medical Oncologist at Academic Institution
The relative benefit might be less, but AI+CDK 4/6i is still better than AI even in patients over 65, so would consider AI+CDK 4/6i in this population also. It would be particularly important to manage toxicity and drug-drug interactions in this population as patients are likely to have more co-morb...
Answer from: Medical Oncologist at Academic Institution
Only in a patient with significant comorbidities not related to the cancer (like a recent stroke) or a very elderly patient with other competing causes of mortality, will I consider starting on an AI alone, with the potential to escalate to the combination if they progress. Subset analysis from PALO...