Endocrine therapy in metastatic breast cancer: a closer look at the current clinical practice

Endocrine therapy is a very effective and well tolerated approach in the treatment of hormone receptor positive metastatic breast cancer. Endocrine therapy has shown comparable results to chemotherapy with regard to survival rates, and therefore, it is recommended in the initial treatment of metastatic breast cancer, except in patients with rapidly progressive disease, where chemotherapy is needed. We have several options of endocrine therapy in first and subsequent lines of treatment in premenopausal and postmenopausal women with metastatic breast cancer, and there has been a great progress in the development of newer agents and combinations. There are few unanswered questions that are raised in the current clinical practice, and more studies are needed to answer them in order to have a better insight of how we may best use endocrine therapy before we need to use chemotherapy. This article will review the current options of treatment and highlight those questions.