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Opinion|Videos|February 4, 2026

Sequencing Endocrine Therapy and CDK4-6 Inhibition

Author(s)Erica L. Mayer, MD, MPH, Kelly E. McCann, MD, PhD

Using the same high-risk patient scenario, the discussion turns to practical strategies for sequencing adjuvant endocrine therapy, ovarian function suppression, and CDK4/6 inhibition.

Episodes in this series

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EP. 1 Defining High-Risk HR-Positive Early Breast Cancer

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EP. 2 Interpreting Long-Term Data From monarchE and NATALEE

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EP. 3 Case 1: Patient Presentation and Risk Assessment

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EP. 4 Sequencing Endocrine Therapy and CDK4-6 Inhibition

Using the same high-risk patient scenario, the discussion turns to practical strategies for sequencing adjuvant endocrine therapy, ovarian function suppression, and CDK4/6 inhibition. The speakers emphasize endocrine therapy as the cornerstone of treatment and describe a stepwise approach to initiating additional agents. Gradual onboarding is highlighted as a way to improve tolerability, adherence, and patient understanding, particularly in premenopausal patients transitioning into medical menopause. The conversation also addresses monitoring, patient education, and the importance of frequent follow-up during early treatment. These insights provide guidance on optimizing long-term adherence while maintaining quality of life.

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