How do you select your first-line endocrine therapy to accompany CDK4/6 inhibitor in metastatic HR+ breast cancer?
Results with fulvestrant and letrozole backbone in MONALEESA and MONARCH trials seem comparable, but PALOMA data is somewhat mixed. How do these trials influence your decision on ET backbone?
Answer from: Medical Oncologist at Academic Institution
If this is a denovo metastatic patient, my choice of endocrine therapy backbone will be an aromatase inhibitor. If the patient develops metastatic disease while on an AI, or within 6-12 months after completing or discontinuing an AI, I will consider fulvestrant. If there is evidence of an ESR1 mutat...