Menna Fouda, Founder & Medical Education Lead – Understanding Cancer with Dr Menna, shared on LinkedIn:
“A question you often find yourself asking as a breast oncologist when treating these patients?”
Therapy after progression on CDK4/6 inhibitors: Key takeaways from Madrid
One of the most practical questions in HR+/HER2- metastatic breast cancer is what comes next once a patient progresses on a CDK4/6i. The conclusions from today’s session gave a clear, biomarker-driven answer:
No targetable mutation
- Gedatolisib triplet or doublet (VIKTORIA-1 study)
- Endocrine therapy + everolimus
- Continuing a CDK4/6i-based therapy after progression (a “post-MONARCH” approach) is a possible option, especially for patients who are naïve to abemaciclib
PIK3CA/AKT pathway mutation? – A targeted PI3K/AKT strategy remains standard
ESR1 mutation? – A targeted ESR1-mutation strategy remains standard
Testing at progression matters, because the biomarker result largely determines the next treatment step.
Treatment sequencing is getting more personalized,
What are you seeing in your clinics? Do you re-test at every progression?”
Follow every key moment of ESMO 2026 with OncoDaily.