Intrinsic subtypes and therapeutic decision-making in hormone receptor-positive/HER2-negative metastatic breast cancer with visceral crisis: A case report
Source : https://www.frontiersin.org/articles/10.3389/fonc.2022.1009352/full
BackgroundCDK4/6 inhibitors (CDKi), namely, palbociclib, ribociclib, and abemaciclib, combined with either an aromatase inhibitor (AI) or fulvestrant are the standard first/second line for hormone receptor-positive(HR+)/HER2-negative(neg) metastatic breast cancer (MBC). However, the choice of one specific CDKi is arbitrary and based on the physician's experience with the drug, toxicity profile, and patient's preferences, whereas biomarkers for optimal patient selection have not been established so far.
Conclusions: This clinical case confirms in the real-world setting that non-luminal subtypes can be found in HR /HER2-neg disease and may have potential therapeutic implications in the metastatic setting. It also questions the recommendation of upfront chemotherapy in the case of a visceral crisis in the era of CDKi-based regimens. These issues merit further evaluation in prospective and larger studies.
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Albert Dekker3yrI can start chemotherapy in 24-72 hours; to get Ibrance from specialty pharmacy 2-4 weeks. so even though Ck4/6 based regimen could be potentially even more effective than chemotherapy from practical standpoint chemo still wins