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Premenopausal Patients With Clinically Aggressive Metastatic Breast Cancer Successfully Treated With a First-Line
Pei-An Fu1, Ya-Chun Hsu2, Hui-Ping Hsu3
1Division of Hematology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Cancer Reports (Hoboken, N.J.)
|December 3, 2025
Summary
First-line palbociclib (a CDK4/6 inhibitor) combined with endocrine therapy shows promise for premenopausal patients with aggressive HR+/HER2- metastatic breast cancer and visceral metastasis.
Area of Science:
- Oncology
- Pharmacology
Background:
- Palbociclib, a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor, is effective for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer with endocrine therapy.
- Chemotherapy is typically recommended for patients with visceral crises, but emerging evidence supports CDK4/6 inhibitors plus endocrine therapy for aggressive visceral metastasis.
Purpose of the Study:
- To evaluate the efficacy of palbociclib and endocrine therapies as initial treatment for premenopausal patients with HR+/HER2- metastatic breast cancer and extensive visceral involvement.
Main Methods:
- Case report of two premenopausal patients with HR+/HER2- metastatic breast cancer and diffuse organ involvement.
- Initial therapy consisted of palbociclib combined with endocrine treatments.
Main Results:
- Both patients achieved adequate and timely responses to first-line palbociclib therapy.
- The combination therapy demonstrated successful management of aggressive visceral metastasis.
Conclusions:
- Frontline palbociclib plus endocrine therapy can be an effective option for premenopausal HR+/HER2- metastatic breast cancer patients with severe visceral metastasis.
- This combination therapy, though not yet widely used, offers a viable treatment choice for this patient subgroup.
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