HR-Positive/HER2-Negative Metastatic Breast Cancer: Oral SERD Sequencing and Emerging Combination Strategies

Dr. Adam Brufsky and the panel continue their discussion of oral SERDs in HR-positive/HER2-negative metastatic breast cancer, focusing on how emerging clinical data may influence treatment sequencing after progression on CDK4/6 inhibitor-based therapy. Dr. Rita Nanda, Dr. Rebecca Shatsky, and Dr. Virginia Kaklamani examine the clinical implications of ESR1 mutation detection and discuss whether treatment modifications should occur in the absence of radiographic progression. The faculty share differing perspectives on balancing early intervention with preserving future treatment options, emphasizing the importance of clinical judgment and individualized patient management. The discussion then shifts to evolving combination endocrine strategies, including studies evaluating oral SERDs in combination with other targeted therapies. The panel reviews key efficacy and safety findings, compares combination approaches with established treatment options, and explores how these regimens may fit into future treatment algorithms. Throughout the conversation, the experts highlight the ongoing need to optimize endocrine-based therapy while maintaining quality of life and extending disease control for patients with HR-positive/HER2-negative metastatic breast cancer.