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ESMO 2026 | How first-line choices shape later treatment in luminal breast cancer

Yeon Hee Park, MD, Samsung Medical Center, Seoul, South Korea, describes strategic sequencing approaches for luminal breast cancer treatment, emphasizing the importance of disease-free interval, prior treatment history, patient and tumor characteristics in determining first-line therapy selection. The choice of endocrine backbone and CDK4/6 inhibitor type influences subsequent second-line treatment decisions, with tumor biomarkers guiding the selection between different treatment modalities. Triplet or quadruplet regimens may additionally extend survival in metastatic disease. This interview took place at the European Society for Medical Oncology (ESMO) 2026 Congress in Madrid, Spain.

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Transcript

This is a main topic of my research and for my patients. Really, strategic sequencing is really important for patients’ overall survival and natural history of luminal breast cancer. But really, it depends on the digit-free interval. And also the previous treatment history, and also patient core morbidity, and then patient aspect, also tumor aspect. And then we need to consider which endocrine backbone should I use for the first line, and then also the CDK4C inhibitor type...

This is a main topic of my research and for my patients. Really, strategic sequencing is really important for patients’ overall survival and natural history of luminal breast cancer. But really, it depends on the digit-free interval. And also the previous treatment history, and also patient core morbidity, and then patient aspect, also tumor aspect. And then we need to consider which endocrine backbone should I use for the first line, and then also the CDK4C inhibitor type. And then maybe that kind of treatment decision may consequently relate to the decision after progression as a second-line treatment strategy. And then to decide the kind of a doublet or triplet or endocrine backbone choosing, most important thing is the biomarker for that tumor. So if there is a special biomarkers, such as PIK3 pathway activation, we prefer to use that kind of real genomic delivery. targeted agent. But otherwise, we can use mostly the CDK4C inhibitor backbone or other cytotoxic chemotherapy or ADC. You know, the reason why we have to do the triplet or sometimes quadruplet is to prolong the patient’s life. Because of metastasized cancer, it’s a really incurable disease at this point. But triplet may be really resulted in long-term survival. But after that, it is a real I would like to address at this stage. And there may be more like chemotherapy replanting agent, such as ADC, for the real next comer after triplet.

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