Will you offer adjuvant abemaciclib to breast cancer patients with high Ki-67 who are unable to receive either neoadjuvant or adjuvant chemotherapy due to comorbidities or who decline chemotherapy?  

Chemotherapy was given to the majority of patients on MonarchE because they were high risk at diagnosis. For patients at high risk, I will continue to offer chemotherapy in addition to adding adjuvant abemaciclib to endocrine therapy. For those patients who refuse or in whom adjuvant chemotherapy is...

That's a leap which is not yet supported by data. I hope we can work to test that hypothesis. The supplemental tables from the MonarchE study show there were 6 more non breast cancer related deaths in the intervention arm in the study, so it's not necessarily a way to avoid toxicity.

I will offer abemaciclib to patients with stage III ER positive breast cancer regardless of whether they agree to adjuvant chemotherapy. In terms of stage II breast cancer with Ki67 over 20%, I will individualize therapy. This may include patients who cannot or possibly will not undergo adjuvant che...

This is a good question. Approximately 95% of the patients in MonarchE received either adjuvant or neoadjuvant chemotherapy. Thus, there is very little data on the benefit of adjuvant abemaciclib in this setting in patients who did not receive chemotherapy. However, and this I think is a clinical ju...