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Endocrine Therapy versus Chemotherapy After CDK4/6 Inhibitor Progression in HR+/HER2- Metastatic Breast Cancer: A
Can Cangür1, Büşra Bülbül1, Irem Turgut Yeğen1
1Department of Medical Oncology, Selcuk University, Konya, Turkey.
Breast Cancer (Dove Medical Press)
|March 23, 2026
Summary
For HR-positive, HER2-negative metastatic breast cancer, continuing endocrine therapy (ET) after CDK4/6 inhibitors offers better survival than chemotherapy. This supports ET as a preferred option post-progression.
Area of Science:
- Oncology
- Medical Research
- Clinical Practice
Background:
- HR-positive, HER2-negative metastatic breast cancer is the most common advanced form.
- CDK4/6 inhibitors plus endocrine therapy are standard first-line treatments.
- Optimal treatment post-progression on CDK4/6 inhibitors is unclear.
Purpose of the Study:
- To compare the efficacy of endocrine therapy (ET) versus chemotherapy (CT) in patients with HR-positive, HER2-negative metastatic breast cancer who progressed on CDK4/6 inhibitors.
- To identify predictors of survival in this patient population.
Main Methods:
- Multicenter retrospective study of 218 patients.
- Patients received either ET or CT after progression on CDK4/6 inhibitors.
- Overall survival (OS) and progression-free survival (PFS) were analyzed.
Main Results:
- ET was associated with significantly longer OS (18.0 vs 10.0 months, p = 0.011) compared to CT.
- PFS showed a numerical advantage for ET (6.0 vs 4.9 months), but not statistically significant.
- De novo metastatic presentation was an independent predictor of survival.
Conclusions:
- Continued endocrine therapy beyond CDK4/6 inhibitor progression yields superior survival compared to chemotherapy in real-world practice.
- Findings support prioritizing endocrine-based approaches over chemotherapy for this patient group.
- Prospective trials are needed to refine treatment sequencing.
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