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Breast Cancer • Medical Oncology
How would you treat a premenopausal patient with ER/PR+, Her2 (-) metastatic breast cancer patient who progresses on tamoxifen?
What is the optimal regimen for a pre-menopausal female with progression of ER+,PR+ and Her2 neu negative breast cancer while on tamoxifen for six months, and metastatic visceral crises now controlled with single agent chemotherapy?
Answer from: Medical Oncologist at Academic Institution
I would give her maintenance fulvestrant high dose with palbociclib given she had progressed on tamoxifen (so combination anastrozole and fulvestrant maintenance will not be an ideal choice). While neither S0226 (first-line and few with acquired or innate resistance) and Paloma 3 (second line or fir...
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Answer from: Medical Oncologist at Academic Institution
I would favor combining ovarian function suppression with an AI and a cdk 4/6 inhibitor (palbociclib or ribociclib, whichever is the least expensive - abemaciclib is not yet approved in this setting though likely will be soon based on data from MONARCH-3 presented at ESMO). While there are no random...
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Medical Oncologist at Private Practice and Digital Health
The use fulvestrant in a premenopausal woman witho...
The use fulvestrant in a premenopausal woman witho...
Medical Oncologist at Warren Alpert Medical School of Brown University
To clarify, of course if you give fulvestrant to a...
To clarify, of course if you give fulvestrant to a...
Answer from: Medical Oncologist at Community Practice
Ovarian suppression plus an AI +/- a CDK 4/6 inhibitor depending on disease pace and prior endocrine sensitivity. Generally, unless rendered postmenopausal, there is a limited role for fulvestrant and it should be avoided in premenopausal women.Although S0226 showed an effect for combined fulvestran...