Claudio Vernieri, MD, PhD, Institut National Du Cancer, Milan, Italy, discusses the impact of CDK4/6 inhibitors combined with endocrine therapy on progression-free and overall survival in HR-positive, HER2-negative advanced breast cancer. Phase III studies like the MONALEESA-2 (NCT01958021), MONALEESA-3 (NCT02422615), MONALEESA-7 (NCT02278120), and the MONARCH 2 (NCT02107703) trials demonstrate significant benefits, supporting their use as first-line therapy. The Phase III SONIA trial (NCT03425838) investigated delaying CDK4/6 inhibitors to second-line treatment with fulvestrant after first-line aromatase inhibitor failure, but found no significant differences in progression-free or overall survival. However, Dr Vernieri critiques the trial’s limitations and questions delaying CDK4/6 inhibitor use. He also highlights the evolving landscape with ribociclib and abemaciclib being used as adjuvant treatments for surgically resected hormone receptor-positive breast cancer, raising new questions about optimal first-line treatment following adjuvant therapy. This interview took place during the 2024 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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