Francisco J. Esteva: The standard of care for hormone receptor-positive, HER2-negative metastatic breast cancer
Francisco J. Esteva, shared a post on LinkedIn:
“Visualize a moment in a bustling healthcare setting, where a 60-year-old woman faces the daunting diagnosis of stage II infiltrating ductal carcinoma. Her journey through breast cancer treatment is marked by choices and challenges. Initially opting for breast conservation surgery, she declined adjuvant radiation and endocrine therapy. Three years later, the cancer returned, this time affecting her bones.
The standard of care for hormone receptor-positive, HER2-negative metastatic breast cancer involves combining cyclin-dependent kinase 4/6 inhibitors with endocrine therapy.
For those with genetic alterations in the PIK3CA pathway, targeted therapies such as inavolisib, alpelisib or capivasertib offer hope.
Patients with mutations in the estrogen receptor ESR1 can be treated with oral selective estrogen receptor downregulators, such as elacestrant.
These treatments can improve progression-free survival, though each comes with its own set of side effects and challenges. The choice between these therapies should consider patient-specific factors, including comorbidities and preferences.
Molecular testing, including liquid biopsies, plays a crucial role in tailoring treatment plans. These tests provide a less invasive method for monitoring tumor dynamics and identifying resistance mutations.
For patients with concurrent ESR1 and PIK3CA mutations, treatment sequencing remains an area of ongoing research and debate.”
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