Dr. Novik on CDK4/6 Inhibitor Combinations in Breast Cancer

Yelena Novik, MD, associate professor, NYU Langone’s Perlmutter Cancer Center, discusses CDK4/6 inhibitor combinations in breast cancer.

Updated data on the MONARCH studies with abemaciclib (Verzenio) were presented at the 2018 ASCO Annual Meeting. Physicians saw some concern in cost issues related to cell-cycle inhibitors, notes Novik, but says they will remain the treatment paradigm as their role as a first- and potentially second-line treatment for patients with advanced breast cancer is uncontested. They prolong disease-free survival and improve quality of life, says Novik, and managing toxicity does not seem to be too challenging.

Premenopausal women should be offered the combination with ovarian suppression as their first-line treatment, says Novik. If these patients did not receive it in the second-line setting, hormonal therapy can also extend their longevity and time to progression. As time goes on, there may be an uptick of neoadjuvant therapy with this combination with hormonal therapy, Novik says. However, that is a relatively unexplored area, especially in older women.