Advances and controversies in adjuvant endocrine treatment strategies for HR+/HER2-early stage breast cancer
10.12354/j.issn.1000-8179.2025.20250759
- VernacularTitle:HR+/HER2-早期乳腺癌辅助内分泌治疗策略的进展与思考
- Author:
Zhang JUN
1
;
Wang YUTONG
1
;
Liu HONG
1
Author Information
1. 天津医科大学肿瘤医院乳腺二科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,乳腺癌防治教育部重点实验室,天津市"肿瘤防治"重点实验室(天津市 300060)
- Publication Type:Journal Article
- Keywords:
HR+/HER2-early stage breast cancer;
endocrine therapy;
CDK4/6 inhibitors
- From:
Chinese Journal of Clinical Oncology
2025;52(18):932-939
- CountryChina
- Language:Chinese
-
Abstract:
Hormone receptor positive/human epidermal growth factor receptor 2 negative(HR+/HER2-)breast cancer is the most common breast cancer subtype,accounting for approximately 65%-70%of breast cancers.Endocrine therapy is the cornerstone of adjuvant therapy.Even with standard endocrine therapies,patients may still experience local and/or systemic recurrence.Recently,with the application of cyc-lin-dependent kinase 4/6(CDK4/6)inhibitors,significant breakthroughs and advances have been made in the adjuvant treatment strategies for HR+/HER2-early stage breast cancer.Both the MonarchE and NATALEE studies were phase Ⅲ clinical trials evaluating CDK4/6 inhibitors in combination with endocrine therapy for the adjuvant treatment of HR+/HER2-early stage breast cancer.These two studies confirmed that CDK4/6 inhibitors in combination with endocrine therapy significantly prolonged invasive cancer-free survival(iDFS),providing a new option for the intensive treatment of patients at a high risk of recurrence.Based on this,CDK4/6 inhibitors were first recommended for use in treat-ing high-risk HR+/HER2-early stage breast cancer by the 2025 Committee of the Breast Cancer Society guidelines.Despite its established ef-ficacy,further research is needed to determine the optimal treatment duration,long-term survival benefits,safety management,and cost-effectiveness.In this study,we have systematically reviewed the latest medical evidence of endocrine therapy for HR+/HER2-early stage breast cancer,and discussed the precision treatment strategy,and look forward to future directions such as circulating tumor DNA(ctDNA)dynamic monitoring,treatment"escalation"and"de-escalation,"novel drug combination and post-resistance treatment strategies in the ad-juvant setting to provide scientific reference for clinical treatment.
