Dr Chen on the Evolution of Novel Therapies in Breast Cancer

Nan Chen, MD, assistant professor, medicine, hematology and oncology (cancer), University of Chicago, UChicago Medicine, discusses the future of CDK4/6 inhibitors in patients with estrogen (ER)–positive, HER2-negative breast cancer.

A variety of cell cycle inhibitors, including CDK4, CDK6, CDK2, and CDK7 inhibitors, are emerging in breast cancer treatment, Chen begins. These inhibitors hold promise when used in combination with existing endocrine therapies and novel therapies in development, potentially leading to more effective treatment regimens in the future, she explains. One goal of current breast cancer research is to explore combinations that offer enhanced efficacy and may replace current treatment standards, Chen says.

Treatments for advanced ER-positive breast cancer following CDK4/6 inhibitor therapy are dynamic and evolving, she expands, saying that there is a growing arsenal of genomic-driven therapies tailored to specific patient populations. As new therapies become available, the sequencing of these treatments becomes critical to optimize outcomes and simultaneously minimize toxicity, according to Chen. Furthermore, efforts are underway to identify biomarkers that predict treatment response and to refine treatment sequencing strategies based on individual patient characteristics, Chen reports.

In the realm of ER-positive breast cancer, CDK4/6 inhibitors continue to serve as a foundational therapy in advanced disease stages; these inhibitors are also making headway in early-stage disease, she continues. Ongoing trials will provide valuable insights into which patient subgroups benefit most from these agents, Chen explains. In the metastatic setting post–CDK4/6 inhibition, there is a diverse array of approved therapies, with a growing emphasis on genomic-guided treatment selection, Chen emphasizes. Additionally, personalized genomic information is increasingly important in guiding treatment decisions for each patient, Chen notes.

Looking ahead, the focus of many breast cancer studies is on integrating newer agents and combination strategies into breast cancer care, she states. The advent of targeted therapies and innovative combinations offers hope for improved outcomes and reduced toxicity for patients, and as research progresses and more data emerge from clinical trials, breast cancer treatment will continue to evolve, Chen concludes.

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Dr Chen on the Investigation of CDK4/6 Inhibitors in Early-Stage Breast Cancer

Nan Chen, MD, assistant professor, medicine, hematology and oncology (cancer), University of Chicago, UChicago Medicine, discusses the investigation of CDK4/6 inhibitors in patients with early-stage breast cancer.

® State of the Science Summit™ on breast cancer, Chen says she primarily focused on CDK4/6 inhibitors in breast cancer, as well as treatment developments beyond CDK4/6 inhibitors concerning other endocrine agents in estrogen receptor–positive breast cancer. Over the past few years, there have been significant changes in breast cancer treatment, particularly with the incorporation of CDK4/6 inhibitors into the early-stage breast cancer treatment arena, she says. These inhibitors are increasingly used for high-risk patients, reflecting a shift in treatment paradigms aimed at optimizing patient outcomes, Chen explains. Moreover, in the metastatic setting, the FDA approvals of several new agents in recent years has prompted clinicians to carefully evaluate trial data and contextual factors to determine the most suitable treatment options for their patients, she adds.

CDK4/6 inhibitors have become a standard of care in breast cancer treatment over the past decade, and their widespread adoption in clinical practice is evident, Chen continues. Additionally, in the metastatic setting, the proven progression-free survival benefits of CDK4/6 inhibitors are well established, and ribociclib (Kisqali) elicits an overall survival advantage in this patient population, she says. Notably, the phase 3 SONIA trial (NCT03425838) trial investigated the use of CDK4/6 inhibitors in combination with either an androgen inhibitor in the first-line setting or fulvestrant (Faslodex) in the second-line setting in patients with hormone receptor–positive advanced breast cancer, Chen reports. This trial provided valuable insights into patient-specific considerations, indicating potential benefits in terms of reduced toxicities when using CDK4/6 inhibitors in the second-line setting, according to Chen.

As new agents and treatment approaches continue to emerge, the optimization of breast cancer treatment will rely on a comprehensive understanding of the efficacy, safety, and patient-specific considerations associated with each therapeutic option, Chen concludes.

Nan Chen, MD, discusses the investigation of CDK4/6 inhibitors in early-stage breast cancer.

Nan Chen, MD

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Dr Chen on the Evolution of Novel Therapies in Breast Cancer

Dr Chen on the Investigation of CDK4/6 Inhibitors in Early-Stage Breast Cancer