Managing a Long and Winding Road: Estrogen Receptor–Positive Breast Cancer

Author:

Gnant Michael1,Turner Nicholas C.2ORCID,Hernando Cristina3

Affiliation:

1. Comprehensive Cancer Center, Medical University of Vienna, Austrian Breast & Colorectal Cancer Study Group, Vienna, Austria

2. The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom

3. Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Valencia, Spain

Abstract

We review key topics in the management of estrogen receptor (ER)–positive human epidermal growth factor receptor 2–negative breast cancer. The single biggest challenge in management of this disease is late relapse, and we review new methods for identifying which patients are at risk of late relapse and potential therapeutic approaches in clinical trials. CDK4/6 inhibitors have become a standard treatment option for high-risk patients in both the adjuvant setting and the first-line metastatic setting, and we review data on optimal treatment after progression on CDK4/6 inhibitors. Targeting the estrogen receptor remains the single most effective way of targeting the cancer, and we review the developments in new oral selective ER degraders that are becoming a standard of care in cancers with ESR1 mutations and potential future directions.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

General Medicine

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