HR-Positive Breast Cancer: Clinical Use of Oral SERDs in Combination vs Monotherapy

This segment explores how emerging data on oral selective estrogen receptor degraders are being applied in clinical practice for hormone receptor–positive, HER2-negative metastatic breast cancer. Dr. Adam Brufsky raises the question of whether early-phase data are sufficient to support the use of oral SERD-based combinations outside of clinical trials.

Dr. Mabel Mardones emphasizes a preference for enrolling patients in clinical trials when possible but notes that, in practice, combination therapy is often favored, particularly for patients with visceral disease or more aggressive progression. She highlights that patient selection is critical, with monotherapy typically reserved for those with limited disease burden or more indolent progression.

Dr. Hope S. Rugo further discusses the rationale for combining oral SERDs with targeted agents, citing emerging safety data and biologic plausibility, particularly in patients with ESR1 mutations and co-occurring pathway alterations. Overall, this segment highlights evolving treatment strategies and the clinical considerations guiding therapy selection.