HR-Positive/HER2-Negative Metastatic Breast Cancer: Integrating Oral SERDs Into Treatment Sequencing

Dr. Adam Brufsky and the panel transition to a discussion of oral selective estrogen receptor degraders (SERDs) and their evolving role in the management of HR-positive/HER2-negative metastatic breast cancer. Drawing on experience from studies evaluating ESR1-mutated disease, Dr. Virginia Kaklamani, Dr. Rebecca Shatsky, and Dr. Rita Nanda discuss factors that may influence patient selection for oral SERD therapy, including prior duration of CDK4/6 inhibitor benefit, endocrine sensitivity, disease biology, and the presence of ESR1 mutations. The faculty review the clinical challenges associated with identifying patients most likely to derive meaningful benefit from endocrine-based approaches and highlight the importance of individualized treatment decisions. The conversation also explores emerging combination strategies involving oral SERDs and targeted therapies, with an emphasis on safety considerations, tolerability, and the need for robust clinical evidence before broader adoption. Throughout the discussion, the panel examines how oral SERDs may fit into treatment sequencing and reflects on the ongoing evolution of endocrine therapy strategies in HR-positive/HER2-negative metastatic breast cancer.