HR-Positive Breast Cancer: Differentiating Oral SERDs and Real-World Decision-Making

This segment explores the challenges of differentiating among multiple oral selective estrogen receptor degraders as they become available for hormone receptor–positive, HER2-negative metastatic breast cancer. Dr. Adam Brufsky raises the question of how clinicians will select between agents with broadly similar efficacy profiles.

Dr. Lisa Raff explains that treatment selection may be influenced by drug–drug interaction profiles, metabolic pathways, and emerging safety signals, including adverse events such as visual disturbances and cardiac effects. She emphasizes the importance of pharmacist involvement in patient education and toxicity management.

Ms. Lori Brisbin highlights that clinical pathways and institutional guidelines will provide structure, but real-world practice will likely include off-label use and individualized decision-making. The discussion also underscores the growing influence of patient preferences and biomarker results, including ctDNA, on treatment decisions. Overall, this segment highlights the complexity of selecting and sequencing oral SERDs in clinical practice.