ASCO GUIDELINES Bundle

Hormone Receptor Positive Metastatic Breast Cancer - Endocrine Therapy

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Steroidal Estradiol 2 mg PO tid Boxed Warning : • Risk of endometrial cancer • Cardiovascular and other risks Fluoxymesterone Not FDA-approved for breast cancer Contraindications: • Known hypersensitivity • Women known or suspected to be pregnant • Patients with serious cardiac, hepatic or renal disease Megestrol acetate 160 mg PO qd Contraindications: • Hypersensitivity Warnings: • Embryo-fetal toxicity Macrolide immunosuppressant – rapamycin (mTOR) inhibitor Everolimus Not FDA-approved for breast cancer Boxed Warning : • Malignancies and serious infections • Kidney graft thrombosis • Nephrotoxicity • Mortality in heart transplantation Table 1. Recommended Pharmaceuticals for HR+ Breast Cancer (cont'd) Agent Dose Comments

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