Breast cancer
NEW --- CDK4/6 inhibitors for everyone? First-line treatment strategies in HR+ HER2- MBC

Kirsten (62 years old)

Kirsten, 62 years old, was diagnosed 7 years ago with a stage III ER+ HER2- breast cancer, and received adjuvant treatment with abemaciclib for 2 years (ended 5 years ago) and letrozole for 5 years (ended 2 years ago). Due to a persistent cough, she underwent a CT scan of the thorax that revealed a suspicious lesion of the right lung.

Assessment summary:

  • Postmenopausal
  • Medical history: smoking (40 pack years)
  • Imaging:
    • 2 cm peribronchial pulmonary lesion of the right lung
    • 4 suspicious lesions in bones (right scapula, sternum, spine)
  • Biopsy of lung lesion: breast cancer, NST, ER 60%, PgR 10%, HER2 IHC 0, G2
  • Haematology: all values normal
  • Germline BRCA-status: wild type
  • Somatic testing: PIK3CA wild type, ESR1 wild type

Which option would you choose for this patient?