Since the approval of cyclin‐dependent kinase 4/6 inhibitors in 2015, this oral cancer (OC) therapy has been combined with oral endocrine therapy as first-line treatment in metastatic hormone receptor–positive breast cancer, adding unique toxicity and complexity to the successful administration of this oral medication.
Estrogen receptor (ER)–positive endometrial cancers (ECs) are characterized by phosphatidylinositol 3-kinase (PI3K) and receptor tyrosine kinase (RTK)/RAS/β-catenin (CTNNB1) pathway alterations in approximately 90% and 80% of cases, respectively.
Approximately 70% of newly diagnosed breast cancers are early-stage, estrogen receptor–positive (ER-positive) and human epidermal growth factor receptor 2–negative (HER2-negative). With optimal adjuvant systemic therapy, including 5-10 years of adjuvant endocrine therapy (ET) with either tamoxifen or an aromatase inhibitor, most patients will be cured, and mortality from breast cancer has declined by over one-third in the past 3 decades.
Since the approval of cyclin‐dependent kinase 4/6 inhibitors in 2015, this oral cancer (OC) therapy has been combined with oral endocrine therapy as first-line treatment in metastatic hormone receptor–positive breast cancer, adding unique toxicity and complexity to the successful administration of this oral medication.
Estrogen receptor (ER)–positive endometrial cancers (ECs) are characterized by phosphatidylinositol 3-kinase (PI3K) and receptor tyrosine kinase (RTK)/RAS/β-catenin (CTNNB1) pathway alterations in approximately 90% and 80% of cases, respectively.
Approximately 70% of newly diagnosed breast cancers are early-stage, estrogen receptor–positive (ER-positive) and human epidermal growth factor receptor 2–negative (HER2-negative). With optimal adjuvant systemic therapy, including 5-10 years of adjuvant endocrine therapy (ET) with either tamoxifen or an aromatase inhibitor, most patients will be cured, and mortality from breast cancer has declined by over one-third in the past 3 decades.
The diagnosis of metastatic ccRCC should be made using tissue biopsy of the primary tumor or a metastatic site with the inclusion of markers and/or stains to support the diagnosis.
Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have emerged as effective treatments for patients with hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2–) advanced/metastatic breast cancer (mBC).
Endocrine therapy has undergone major changes in the past few years, and is no longer a “one-size-fits-all” prescription. This article discussed some of the new developments and directions.
Liquid biopsies in metastatic renal cell carcinoma (mRCC) provide a unique approach to understand the molecular basis of treatment response and resistance. This is particularly important in the context of immunotherapies, which target key immune-tumor interactions.
In recent years, unprecedented benefits have been observed with the development of cyclin-dependent kinase (CDK) 4 and 6 inhibitors for the treatment of hormone receptor–positive/human epidermal growth factor receptor 2–negative metastatic breast cancer.
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches.
The PALLAS study investigated whether the addition of palbociclib, an oral CDK4/6 inhibitor, to adjuvant endocrine therapy (ET) improves invasive disease-free survival (iDFS) in early hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer. In this analysis, we evaluated palbociclib exposure and discontinuation in PALLAS.
The last few decades witnessed remarkable advancements in the treatment of estrogen receptor–positive (ER+) metastatic breast cancer (MBC). The identification of the ER pathway, as well as consequently the development of safe and effective targeted therapies, has expanded the range of available effective treatments.
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches.
Antiestrogen therapy remains the targeted therapy par excellence in treating metastatic hormone receptor–positive breast cancer. The advent of novel agents, such as cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors, to overcome common mechanisms of endocrine resistance only reinforces the central role of antiestrogen therapy in estrogen receptor–positive (ER+) metastatic breast cancer (MBC).
The natural history of hormone receptor–positive breast cancer tends to be more favorable than other subtypes such as human epidermal growth factor receptor 2–amplified and triple-negative. In addition, the natural dependence on steroid hormone signaling has allowed for therapeutic targeting of this pathway and significant improvements in survival while maintaining quality of life: the two main goals in management of the disease.
Renal cell carcinoma (RCC) is an umbrella term for a collection of vastly different malignancies originating in the kidney, with varying prognosis and clinical behavior. On the broadest scale, RCC can be subdivided into the clear cell and non–clear cell categories.
This analysis evaluated the genomic landscape of premenopausal patients with hormone receptor–positive and human epidermal growth factor receptor 2–negative advanced breast cancer and the association of genetic alterations with response to ribociclib in the phase III MONALEESA-7 trial.
Patients and providers often lack clinical decision tools to enable effective shared decision making. This is especially true in the rapidly changing therapeutic landscape of metastatic kidney cancer.
To update recommendations of the ASCO systemic therapy for hormone receptor (HR)-positive metastatic breast cancer (MBC) guideline.
Three cyclin-dependent kinase 4/6 inhibitors (CDKIs) are approved by the US Food and Drug Administration for the treatment of patients with hormone receptor–positive, human epidermal growth factor receptor 2–negative advanced or metastatic breast cancer in combination with hormonal therapy (HT).
In the phase III SOLAR-1 trial (NCT02437318), the PI3Kα-selective inhibitor and degrader alpelisib significantly improved median progression-free survival when added to fulvestrant in patients with phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)–mutated, hormone receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer.
A large-panel gene expression analysis was conducted to identify biomarkers associated with the effectiveness of adding palbociclib to fulvestrant.
We conducted a focused review of hallmark randomized controlled trials informing the systemic treatment of patients with RCC. We concentrated on trials informing the use of combination therapies, therapy in both treatment-naïve and previously treated patients, sequential treatment strategies, and schedules.
Although kidney cancer (renal cell carcinoma [RCC]) is susceptible to immunotherapy, the immunologic aspects of the tumor microenvironment (TME) in RCC are relatively unique among tumor types. In RCC, baseline CD8 T-cell infiltration is associated with a worse prognosis.
The management of advanced kidney cancer was once fairly straightforward when it was considered a single disease. However, we now recognize more than a dozen histologic subtypes with unique biology.
The role of targeted therapy (TT) in metastatic renal cell carcinoma (mRCC) having non-clear cell histology (non-ccRCC) is still being defined. We sought to examine the factors associated with survival outcomes in patients presenting with various histological subtypes in the TT era.
For patients with T1a renal cell carcinoma (RCC), partial nephrectomy (PN) is now the standard of care, with similar cancer control and better long term kidney function than radical nephrectomy (RN).
Background: Axitinib is an oral, potent, and selective inhibitor of VEGF receptors 1, 2, and 3. This randomized, open-label, phase III trial compared the efficacy and safety of axitinib versus (vs) sorafenib as second-line therapy for mRCC.
Current pathology and clinical methods do not accurately estimate risk of recurrence in all patients with pT1 ccRCC. Quantitative RT-PCR (qPCR) analysis was performed on resected ccRCC tumors to identify genes associated with recurrence that significantly augment current prognostic tools.