Hermione Exchange Educational Program: How to Integrate Multidisciplinary Approaches to Manage HR+/HER2- Metastatic...

Area of Science:

• Oncology
• Medical Education
• Translational Research

Background:

• Luminal breast cancer treatment complexity necessitates clear management strategies for disease recurrence.
• Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are standard first-line therapy, with progression requiring optimized subsequent treatment.
• Understanding treatment decisions post-CDK4/6 inhibitor progression is vital for clinical practice.

Purpose of the Study:

• To characterize clinical decision-making regarding second-line treatment after CDK4/6 inhibitor progression in luminal breast cancer.
• To assess the influence of metastasis site, patient factors, and molecular status on treatment choices.
• To highlight the importance of genomic testing and multidisciplinary collaboration in managing advanced breast cancer.

Main Methods:

• An educational program (Hermione Exchange) involving lectures and workshops was conducted.
• Two questionnaires assessed oncologists' approaches to targeted therapy versus chemotherapy after CDK4/6 inhibitor progression.
• Case studies illustrated patient scenarios with different progression patterns.

Main Results:

• Liver metastases (69%) and lung metastases (50%) strongly influenced the decision to initiate chemotherapy.
• Patient chemotherapy willingness (88%) and comorbidities (81%) were significant drivers for treatment selection.
• Duration of response, molecular status, and patient condition are key factors for second-line therapy decisions.

Conclusions:

• Genomic testing at diagnosis and during treatment is recommended for monitoring disease and guiding therapy.
• Integrating clinical experience with evolving molecular insights is essential for optimal patient management.
• Multidisciplinary collaboration among oncologists, pathologists, and molecular biologists is key to personalized treatment selection.