Dr. Gandhi and Dr. Clifton discuss incorporating imlunestrant plus abemaciclib into treatment sequencing for hormone receptor–positive/HER2-negative (HR+/HER2–) metastatic breast cancer (BC), considering factors such as ESR1 mutation status, prior CDK4/6 inhibitor (CDK4/6i) use, and visceral metastases, while also highlighting key trials of selective estrogen receptor degraders (SERDs), including SERENA-2 and OPERA-01.
Based on the data seen in the EMBER-3 trial, how do you anticipate incorporating imlunestrant plus abemaciclib into your treatment sequencing for patients with HR+/HER2– metastatic BC? In which patients and in which line of therapy would you consider using this combination?
Based on subgroup data, how might you consider these factors in your clinical decision-making?
ESR1 mutation vs wild type
Prior CDK4/6i
Duration of prior CDK4/6i
Presence of visceral metastases
Please highlight other trials of note investigating SERDs in HR+/HER2– BC:
SERENA-2: camizestrant vs fulvestrant
OPERA-01: palazestrant vs standard-of-care endocrine therapy