ASCO GUIDELINES Bundle

Hormone Receptor Positive Metastatic Breast Cancer - Endocrine Therapy

ASCO GUIDELINES App Bundle brought to you fcourtesy of Guideline Central. All of these titles are available for purchase on our website, GuidelineCentral.com. Enjoy!

Issue link: https://eguideline.guidelinecentral.com/i/770592

Contents of this Issue

Navigation

Page 6 of 9

Figure 2. Hormone Therapy for Premenopausal Women with HR+ Metastatic Breast Cancer No prior adjuvant endocrine therapy Note. Use of palbociclib should be reserved for patients without prior exposure to cyclin-dependent kinase 4/6 inhibitors. Fulvestrant should be administered at 500 mg every 2 weeks for three cycles, then once per month as an intramuscular injection. Withdrawal of tamoxifen or progestins was reported to result in short-term disease responses in older literature. Steroidal = exemestane; nonsteroidal = anastrozole or letrozole. Prior adjuvant endocrine therapy Prior treatment with tamoxifen with or without ovarian suppression Prior treatment with an Al and ovarian suppression Early relapse (≤ 12 months since adjuvant therapy) Late relapse (> 12 months since adjuvant therapy) Early relapse (≤ 12 months since adjuvant therapy) Late relapse (> 12 months since adjuvant therapy) OS plus: • Al (nonsteroidal) • Fulvestrant (500 mg) • Al + palbociclib OS plus: • Al (nonsteroidal) • Al + fulvestrant • Al + palbociclib • Tamoxifen OS plus: • Fulvestrant ± palbociclib • Al + everolimus • Al (steroidal) • Tamoxifen OS plus: • Al (nonsteroidal) • Fulvestrant • Al + palbociclib • Tamoxifen • Fulvestrant ± palbociclib • Al + everolimus • Al (steroidal) • Tamoxifen (late relapse) Depending on prior therapy: • Fulvestrant ± palbociclib • Al + everolimus • Al (steroidal) • Tamoxifen Sequential therapy based on prior exposure and response to hormone therapy • Estradiol (2 mg tid) • Megestrol acetate • Fluoxymesterone • Reintroduction of prior therapy OS plus: • Al, nonsteroidal preferred • Al + fulvestrant • Al + palbociclib • Tamoxifen • Fulvestrant ± palbociclib • Al + everolimus • Al (steroidal) • Tamoxifen First-line Second-line (with continued OS) Third-line or greater

Articles in this issue

Archives of this issue

view archives of ASCO GUIDELINES Bundle - Hormone Receptor Positive Metastatic Breast Cancer - Endocrine Therapy