William J. Gradishar, MD, FASCO FACP, Feinberg School of Medicine, Chicago, IL, discusses the evolution of adjuvant endocrine therapy for hormone-sensitive breast cancer. He highlights the historical use of tamoxifen or aromatase inhibitors for five years, with recent trials exploring different durations and sequences of therapy. Prof. Gradishar emphasizes the introduction of CDK4/6 inhibitors in metastatic breast cancer treatment and the subsequent interest in their potential benefits in early-stage disease. He reviews trials with palbociclib, ribociclib, and abemaciclib, noting the failure of palbociclib trials and the success of abemaciclib trials, particularly the Phase III monarchE trial (NCT03155997) showing sustained improvement in outcome with abemaciclib in high-risk patients. He also discusses the ongoing Phase III NATALEE trial (NCT03701334) with ribociclib, demonstrating fewer recurrences with three years of therapy. This interview took place at the 2024 PRIMO meeting in Honolulu, Hawaii.
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