| Consensus Statement | Quality of Evidence | Strength of Rec. | Key Ref |
|---|---|---|---|
| 1. ET with CDK 4/6 inhibitor is standard of care in 1st line therapy for themajority of ER+/ HER2-advancedbreast cancer patients, including those with clinically aggressive disease. #Definition of aggressive ABC:symptomatic visceral metastases, rapid disease progression or impending visceral compromise, marked non- visceral-diseasebut withtotal bilirubin <1.5ULN. | I | A | 1 |
| 2. ET with CDK 4/6 inhibitor maybe consideredafter surgical resection or radiotherapy for clinically stable CNS metastasis. | II | B | 2 |
| 3. ET with CDK4/6 inhibitor is effective both in luminal A and luminal B subgroups.* *The subgroups refer to PAM50 defined intrinsic subtypes, rather than clinicopathologic subtypes. | II | B | 3 |
References
- Yen-Shen Lu, et al. Primary results from the randomized Phase II RIGHT Choice trial of premenopausal patients with aggressive HR+/HER2 − advanced breast cancer treated with ribociclib + endocrine therapy vs physician’s choice combination chemotherapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr GS1-10.
- Cottu, Paul et al. “Ribociclib plus letrozole in subgroups of special clinical interest with hormone receptor-positive, Human epidermal growth factor receptor 2-negative advanced breast cancer: Subgroup analysis of the phase IIIb CompLEEment-1 trial.” Breast (Edinburgh, Scotland) vol. 62(2022): 75-83.doi:10.1016/j.breast.2022.01.016.
- Alexi Prat et al. Correlative Biomarker Analysis of Intrinsic Subtypes and Efficacy Across the MONALEESA Phase III Studies. J Clin Oncol . 2021 May 1;39(13):1458-1467.