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The results of the MONARCH 3 trial showed that adding the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib to endocrine therapy improved progression-free survival compared to endocrine therapy alone in the total study population. Abemaciclib reduced the risk of disease progression by 46%.
“This is the third study demonstrating that the combination of endocrine therapy with a CDK4/6 inhibitor is better than endocrine therapy alone,” said lead author Dr Angelo Di Leo, medical oncologist, Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy.
Commenting on the findings, Dr Giuseppe Curigliano, director, Division of New Drug Development, European Institute of Oncology (IEO), University of Milan, Milan, Italy, said: “Abemaciclib is the third CDK4/6 inhibitor to be tested in advanced breast cancer and the MONARCH 3 trial confirms the role of this new class of agents in combination with endocrine therapy in the treatment of metastatic breast cancer.”
“Many patients with metastatic disease still receive chemotherapy, despite guidelines and data from clinical trials,” he added. “This study confirms that we should avoid chemotherapy in hormone receptor positive, HER2 negative metastatic breast cancer if visceral crisis is not present.”
Curigliano concluded: “The major question that still needs to be answered is the optimal sequence of treatment in the era of CDK 4/6 inhibitors. Should we use these agents in the first line setting or is there a space to start with endocrine therapy alone and to add CDK 4/6 inhibitors at progression? An academic driven trial should be designed to address this question.”
This session was recorded at the ESMO 2017 Congress in Madrid