HR-Positive/HER2-Negative Metastatic Breast Cancer: ESR1 Mutation Monitoring and the Evolving Role of Oral SERDs

Dr. Adam Brufsky leads a discussion on one of the most debated topics in HR-positive/HER2-negative metastatic breast cancer: the use of oral SERDs and the potential role of molecular monitoring to guide treatment changes before radiographic progression. Dr. Virginia Kaklamani, Dr. Rebecca Shatsky, and Dr. Rita Nanda examine emerging data evaluating ESR1 mutation-directed treatment strategies and discuss the opportunities and challenges associated with intervening based on molecular progression. The panel reviews the strengths and limitations of recent clinical trials, highlighting important considerations related to study design, patient selection, crossover opportunities, and interpretation of progression-free survival outcomes. The faculty also discuss the practical implications of routine liquid biopsy testing, including issues related to cost, accessibility, and implementation across diverse practice settings. Throughout the conversation, the experts explore how evolving biomarker-driven approaches may influence future treatment sequencing while emphasizing the need for additional evidence to determine how best to integrate molecular monitoring and oral SERDs into the management of HR-positive/HER2-negative metastatic breast cancer.