Danielle Roman, PharmD, Allegheny Health Network Cancer Institute, recently presented at the 2023 Specialty Pharmacy Next meeting and provided updates in the treatment of breast cancer.

According to the current data that Dr Roman kicked off the session with, there are 297,790 estimated new cases in 2023—69% being HR+/HER2-. However, Dr Roman noted that this cancer type does have the best survival pattern.

Right now, the treatment overview for early-stage breast cancer includes surgery, +/- radiation, endocrine therapy, +/- chemotherapy, and +/- targeting therapy.

Dr Roman explained that current CDK 4/6 inhibitors include Abemaciclib, Palbociclib, and Ribociclib. All of these treatments are approved for metastatic breast cancer and only Abemaciclib is approved for early stage, too.

Overall, Dr Roman said the key takeaways for early-stage breast cancer included:

• Adjuvant abemaciclib for 2 years plus endocrine therapy ( ET) is recommended for patients with HR+ HER2- lymph node plus disease and high-risk feature(s);
• Adjuvant ribociclib for 3 years plus ET improves invasive disease-free survival for patients with HR+ HER2- stage II or III disease;
• Adverse effect profile is manageable and consistent with use in the metastatic setting.

Next, Dr Roman reviewed various updates in metastatic breast cancer. The current treatment overview for this cancer type includes endocrine therapy, targeted therapy, chemotherapy, and antibody-drug conjugates.

Dr Roman said “Elacestrant is a treatment option for patients with HR+ HER2- ESR1-mutated breast cancer in the 2nd line or beyond, and fixed-dose capecitabine (1500 mg PO BID 7 days on, 7 days off) has less toxicity and similar efficacy compared to standard-dose capecitabine for metastatic breast cancer.”