ASCO 2023 | SONIA: optimal CDK4/6 inhibitor position in HR+, HER2- advanced BC

Gabe Sonke, MD, PhD, Netherlands Cancer Institute, Amsterdam, The Netherlands, discusses the Phase III SONIA (NCT03425838) trial evaluating the efficacy, safety, and cost-effectiveness of CDK4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) in HR+, HER2- advanced breast cancer (ABC) patients with no prior ABC treatment. Patients were randomized to receive either CDK4/6i + ET as first-line treatment followed by fulvestrant (F) on progression (strategy A) or ET alone as first-line followed by F + CDK4/6i on progression (strategy B). After a median follow-up of 37.7 months, there was no statistically significant difference in progression-free survival (PFS2) between the two strategies. Strategy A prolonged time on CDK4/6i by 16.4 months but also increased toxicity and costs. Second-line use of CDK4/6i may be a preferred option for most patients with HR+, HER2- ABC. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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