Advancements in Treatment Selection and Sequencing in HER2-Positive Metastatic Breast Cancer: Insights from ASCO 2025 - Episode 2
Panelists discuss how the PATINA trial data showing improved progression-free survival with CDK4/6 inhibitor maintenance therapy after CLEOPATRA induction is becoming practice-changing for patients with hormone receptor–positive disease.
CDK4/6 Inhibitor Integration: PATINA Trial
The PATINA trial represents a significant advancement in optimizing treatment for HER2-positive, hormone receptor–positive metastatic breast cancer (mBC). This study evaluated adding palbociclib (a CDK4/6 inhibitor) to endocrine therapy as maintenance treatment following induction with the CLEOPATRA regimen. The trial demonstrated marked improvement in progression-free survival, supporting the concept of dual pathway targeting in patients with both HER2 and hormone receptor positivity.
This approach addresses a gap in treatment optimization, as CDK4/6 inhibitors had not been routinely used in HER2-positive disease despite their success in hormone receptor–positive, HER2-negative breast cancer. The PATINA study results are considered practice-changing, though formal inclusion in treatment guidelines is pending. The regimen is expected to influence future treatment algorithms, particularly when compared with other emerging first-line options.
The study has implications for treatment sequencing, especially as new data from trials like DESTINY-Breast09 emerge. Oncologists anticipate that PATINA will likely be incorporated into treatment guidelines based on the compelling efficacy data, representing a well-tolerated option for patients with hormone receptor–positive disease that leverages both HER2 and estrogen receptor pathways simultaneously.