Individualizing the Selection of First-Line Therapy for Patients with Hormone Receptor-Positive Metastatic Breast Cancer: Impact of Biomarkers and Existing Comorbidities — Video Interview

Faculty

TARGET AUDIENCE
This activity is intended for medical oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of breast cancer.

LEARNING OBJECTIVES

• Discern the mechanism by which the cyclin-dependent kinase (CDK) pathway contributes to breast cancer proliferation and growth, and consider the clinical and research implications for the management of hormone receptor (HR)-positive metastatic breast cancer (mBC).
• Appraise published findings from randomized clinical trials and real-world experience establishing the efficacy and safety of CDK4/6 inhibitors for HR-positive mBC in order to understand the risks, benefits and optimal use of these agents in various subgroups of patients.
• Implement a clinical plan for the treatment of newly diagnosed HR-positive mBC, considering patient age, performance status, preexisting medical conditions, prior treatments and other clinical and practical factors.
• Develop preventive and emergent strategies to reduce or ameliorate the unique side effects associated with the various approved CDK4/6 inhibitors.

ACCREDITATION STATEMENT
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
Video Interview: Research To Practice designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Video Lecture: Research To Practice designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
Successful completion of these CME activities, which includes participation in the evaluation components and post-tests, enables the participant to earn up to 1.25 (video) and 0.75 (lecture) Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for each activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Please note, these programs have been specifically designed for the following ABIM specialty: medical oncology.

AMERICAN BOARD OF SURGERY (ABS) — CONTINUOUS CERTIFICATION (CC)
Successful completion of these CME activities, which includes participation in the evaluation components and post-tests, enables the learner to earn credit toward the CME and Self-Assessment requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABS credit.

Please note, these programs have been specifically designed for the following ABS practice area: complex general surgical oncology.

PRIVACY POLICY
Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

HOW TO USE THIS CME ACTIVITY
To receive credit for an activity in this series, the participant should review the CME information, listen to or view the MP3s, review the downloadable slide set, complete the post-test with a score of 80% or better and fill out the evaluation. Program location URLs are noted below:

Video Interview: ResearchToPractice.com/HRPosmBCComorbidities24/Video and evaluation ResearchToPractice.com/HRPosmBCComorbidities24/Video/CME.

Video Lecture: ResearchToPractice.com/HRPosmBCComorbidities24/Presentation and evaluation ResearchToPractice.com/HRPosmBCComorbidities24/Presentation/CME.

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education and adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of an accredited continuing education activity, including faculty, planners, reviewers and others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of this activity. In addition, all activity content is reviewed by RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty reported relevant financial relationships with ineligible entities:

Adam M Brufsky, MD, PhD
Professor of Medicine
UPMC Hillman Cancer Center
Department of Medicine
University of Pittsburgh
Pittsburgh, Pennsylvania

Consulting Agreements: Agendia Inc, AstraZeneca Pharmaceuticals LP, BriaCell, Daiichi Sankyo Inc, Genentech, a member of the Roche Group, Gilead Sciences Inc, Jazz Pharmaceuticals Inc, Lilly, Merck, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Pfizer Inc, Puma Biotechnology Inc, Sanofi.

EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following companies: AbbVie Inc, ADC Therapeutics, Alexion Pharmaceuticals, Amgen Inc, Array BioPharma Inc, a subsidiary of Pfizer Inc, Arvinas, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, BeiGene Ltd, Black Diamond Therapeutics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Clovis Oncology, Coherus BioSciences, CTI BioPharma, a Sobi Company, Daiichi Sankyo Inc, Eisai Inc, Elevation Oncology Inc, Exact Sciences Corporation, Exelixis Inc, Genentech, a member of the Roche Group, Genmab US Inc, Geron Corporation, Gilead Sciences Inc, GSK, Hologic Inc, ImmunoGen Inc, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Karyopharm Therapeutics, Kite, A Gilead Company, Legend Biotech, Lilly, MEI Pharma Inc, Merck, Mersana Therapeutics Inc, Mirati Therapeutics Inc, Mural Oncology Inc, Natera Inc, Novartis, Novartis Pharmaceuticals Corporation on behalf of Advanced Accelerator Applications, Novocure Inc, Nuvalent, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Rigel Pharmaceuticals Inc, R-Pharm US, Sanofi, Seagen Inc, Servier Pharmaceuticals LLC, SpringWorks Therapeutics Inc, Stemline Therapeutics Inc, Syndax Pharmaceuticals, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc, TerSera Therapeutics LLC, and Tesaro, A GSK Company.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts of interest to disclose.

These educational activities contain discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantor.

These activities are supported by an educational grant from Pfizer Inc.

Release date: April 2025
Expiration date: April 2026

After completing the post-test, learners may download and review the answers here in order to identify further areas of study.

Blum JL et al. Impact of comorbidities on real-world patient-reported outcomes of patients (pts) with hormone receptor-positive human epidermal growth factor 2-negative (HR+/HER2-) advanced breast cancer (ABC) enrolled in the POLARIS trial. ESMO 2023;Abstract 461P.

Brufsky A et al. Overall survival with palbociclib (PAL) plus an aromatase inhibitor (AI) versus AI alone in older patients (pts) with de novo, HR+/HER2− metastatic breast cancer: A SEER-Medicare analysis. ASCO 2024;Abstract 1111.

Brufsky A et al. Palbociclib plus aromatase inhibitors in patients with metastatic breast cancer and cardiovascular diseases: Real-world effectiveness. Oncologist 2024;29(12):1032-43. Abstract

Brufsky A et al. Real-world comparative efficacy of CDK4/6 inhibitors in first-line treatment of HR+/HER2- metastatic breast cancer. San Antonio Breast Cancer Symposium 2024;Abstract P2-09-30.

Brufsky A et al. Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: A SEER registry analysis of patients with HER2- and HER2+ metastatic breast cancer. Breast Cancer Res Treat 2024;208(2):223-35. Abstract

Brufsky A et al. Real-world effectiveness of palbociclib plus letrozole vs letrozole alone for metastatic breast cancer with lung or liver metastases: Flatiron database analysis. Front Oncol 2022;12. Abstract

Finn RS et al. Overall survival (OS) with first-line palbociclib plus letrozole (PAL+LET) versus placebo plus letrozole (PBO+LET) in women with estrogen receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer (ER+/HER2− ABC): Analyses from PALOMA-2. ASCO 2022;Abstract LBA1003.

Llombart-Cussac A et al. PARSIFAL-LONG: Extended follow-up of hormone receptor-positive/HER2-negative advanced breast cancer patients treated with fulvestrant and palbociclib vs. letrozole and palbociclib in the PARSIFAL study. San Antonio Breast Cancer Symposium 2023;Abstract RF01-03.

Onesti CE, Jerusalem G.CDK4/6 inhibitors in breast cancer: differences in toxicity profiles and impact on agent choice. A systematic review and meta-analysis. Expert Rev Anticancer Ther 2021;21(3):283-98. Abstract

Rocque GB et al. Laboratory monitoring in patients with hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2–) advanced breast cancer treated with palbociclib in a real-world setting: Results from POLARIS. San Antonio Breast Cancer Symposium 2022;Abstract P3-01-05.

Rocque G et al. Real-world quality of life (QoL) in patients with HR+/HER2-advanced breast cancer (ABC) treated with palbociclib: Final clinical outcome assessment (COA) analysis from POLARIS. ESMO 2022;Abstract 266P.

Rugo HS et al. Comparative overall survival of CDK4/6 inhibitors plus an aromatase inhibitor in HR+/HER2- metastatic breast cancer in the US real-world setting. ESMO Open 2025;10(1):104103. Abstract

Rugo HS et al. Overall survival with first-line palbociclib plus an aromatase inhibitor (AI) vs AI in metastatic breast cancer: A large real-world database analysis. ESMO Breast Cancer 2022;Abstract 169P.

Rugo HS et al. Real-world study of overall survival with palbociclib plus aromatase inhibitor in HR+/HER2- metastatic breast cancer. NPJ Breast Cancer 2022;8(1):114. Abstract

Rugo HS et al. Real-world treatment patterns of palbociclib plus an aromatase inhibitor or aromatase inhibitor alone for metastatic breast cancer in the Flatiron database. San Antonio Breast Cancer Symposium 2022;Abstract P3-01-14.

Tripathy D et al. Characterization of neutropenia in patients with hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2–) advanced breast cancer on palbociclib in a real-world setting: Results from POLARIS. San Antonio Breast Cancer Symposium 2022;Abstract P3-01-03.

Tripathy D et al. POLARIS: A prospective, multicenter, noninterventional study assessing palbociclib in hormone receptor-positive advanced breast cancer. Future Oncol 2020;16(31):2475-85. Abstract