Optimizing Timing of Adjuvant CDK4/6 Inhibitor Initiation in Clinical Practice

This segment focuses on the practical considerations surrounding the initiation of adjuvant CDK4/6 inhibitor therapy after surgery and other planned treatments. The faculty discuss how chemotherapy, radiation therapy, endocrine therapy, and ovarian suppression influence treatment sequencing and timing in everyday practice. They review the timing windows established in the monarchE and NATALEE clinical trials and consider how these data can be applied when patients experience delays or require individualized treatment schedules. The conversation also highlights the importance of patient education before treatment begins, ensuring that patients understand the overall treatment plan and expectations for long-term therapy. Looking ahead, the panel examines ongoing research evaluating chemotherapy de-escalation and the potential role of genomic risk assessment in guiding treatment decisions. The discussion concludes with consideration of how treatment sequencing may affect patient adherence and persistence with adjuvant therapy over time.