Updates in the Treatment of HR+/HER2- Breast Cancer - Episode 1

Diagnosis and Risk Stratification for Early-Stage HR+/HER2- Breast Cancer

Panelists discuss how the NCCN guidelines for risk stratification in HR+/HER2- early-stage breast cancer inform clinical decision-making, with an emphasis on biomarker testing, the use of tools like RSClin N+, and the evolving role of CDK4/6 inhibitors and adjuvant therapies. They also address challenges in risk assessment and the integration of newer treatment strategies, such as CDK4/6 inhibitors and PARP inhibitors in the early-stage setting.

Video content above is prompted by the following:

  • What are the key NCCN guidelines for risk-stratifying patients with HR+, HER2- early-stage breast cancer (eBC)?
  • How closely does overall real-world practice follow these guidelines?
  • Can you please describe your approach to diagnosing and stratifying HR+, HER2- breast cancer at an early stage? 
  • What clinical scenarios make risk stratification complex?
  • How do you define “high risk” in this setting?
  • What are your thoughts on the RSClin N+ tool (ASCO 2024)
  • What biomarkers do you typically test for in HR+/HER2- eBC? (hormone receptor, progesterone receptor, HER2, others?)
  • What testing methodologies are most used (next-generation sequencing, fluorescence in situ hybridization, immunohistochemistry, panels, etc)?
  • How do they differ, and what can you learn from each?
  • Do you ever check circulating tumor DNA?
  • How do various testing results guide your treatment approach?
  • Please briefly describe the predominant role of CDK4/6i in HR+/HER2- eBC.
  • Given your experience and the positive trials in the metastatic setting, how comfortable are you with using CDK4/6i in eBC?
  • Could you provide an overview of current treatment options for eBC?
  • What are the limitations of current treatments?
  • How are newer strategies like adjuvant CDK4/6 and PARP inhibitors changing the paradigm?
  • What is the rationale for combining CDK4/6 inhibitors with endocrine therapy in eBC?