How do you decide among approved CDK4/6 inhibitors for first line treatment of patients with metastatic HR+ breast cancer now that OS analyses are available in MONALEESA-2, MONARCH-3 and PALOMA-2?  

Updated Answer 1/23/24: I was asked to update my prior answer in light of final OS results from the MONARCH 3 trial, which read out at SABCS, and comment on whether this would impact my treatment selection.   While MONARCH-3 did not show a statistically significant OS benefit, the difference...

I prefer Abema as I find I do not have to hold or change dose as much for counts or LFTs. I don't like having to get EKGs. I find my patients prefer daily dosing which actually leads to better Rb suppression and avoids rebound that is seen with intermittent dosing. Also, it inhibits CDK4 more and ha...

Tough situation. On one hand, there is overall survival benefit with ribociclib (and abemaciclib in IA), the results were not statistically significant with palbociclib. This could be due to differences in study power (OS was secondary endpoint), post-PFS follow up (large no. of drop outs in PALOMA)...

I discuss with my patients that three CDK4/6 inhibitors are available, and that they have never been formally compared to each other. In many cases, the choice of CDK4/6 inhibitor can be made based on the expected toxicity profile of each drug considering each patient’s pre-existing medical co...

Unfortunately, it is more than unlikely that there will ever be a head to head comparison of all three CDK inhibitors. We have to try to interpret the available data and make individual patient related choices. Updated survival data from ESMO 2022 on abemaciclib showing overall survival of 67.9 mon...