HR-Positive Breast Cancer: Sequencing Challenges and Future Treatment Strategies with Oral SERDs

This segment explores emerging challenges in treatment sequencing for hormone receptor–positive, HER2-negative metastatic breast cancer as oral selective estrogen receptor degraders move into earlier lines of therapy. Dr. Adam Brufsky raises key questions regarding how to manage disease progression after exposure to oral SERDs and whether sequential use of similar agents will remain effective.

Dr. Hope S. Rugo discusses variability across clinical trials and highlights the difficulty of comparing outcomes due to differences in patient populations and endocrine sensitivity. She notes that the addition of CDK4/6 inhibitors may attenuate the incremental benefit of specific endocrine agents, raising important considerations for combination strategies.

Dr. Mabel Mardones adds that trial design, patient selection, and choice of combination partner remain critical factors influencing outcomes. The discussion also emphasizes the growing role of real-world data and smaller studies in guiding future decisions. Overall, this segment highlights ongoing uncertainty in sequencing strategies and the need for continued clinical investigation.