Dr. Denduluri on Treatment for ER+/HER2- Breast Cancer

Neelima Denduluri, MD, medical oncologist, Virginia Cancer Specialists, discusses treatment for patients with estrogen receptor (ER)-positive, HER2-negative breast cancer.

There are several therapies available for patients with ER-positive, HER2-negative breast cancer. Although CDK4/6 inhibitors have transformed the way these patients are treated, physicians have had access to potent targeted therapies for decades, including tamoxifen, fulvestrant, aromatase inhibitors, and other anti-estrogen agents. However, these agents used in combination with CDK4/6 inhibitors have resulted in tremendous strides for patients with stage IV breast cancer, says Denduluri. Further, physicians are anticipating the introduction of the PIK3CA inhibitor, alpelisib (BYL719).

The CDK4/6 inhibitors have transformed how physicians treat ER-positive, HER2-negative breast cancer in the metastatic setting, adds Denduluri. They’ve delayed the time to chemotherapy by more than double that of historical standards. All 3 inhibitors—–ribociclib (Kisqali), palbociclib (Ibrance), and abemaciclib (Verzenio) are oral drugs that enhance the efficacy of current anti-estrogen therapy. Regardless of the extent of disease, age of the patient, or pre/postmenopausal status, CDK4/6 inhibitors improve outcomes for patients when used in combination with anti-estrogen therapy, concludes Denduluri.