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Cancers
Special Issues
State-of-the-Art and Perspectives in the Treatment of Hormone-Receptor-Positive Breast Cancer
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State-of-the-Art and Perspectives in the Treatment of Hormone-Receptor-Positive Breast Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (15 April 2024) | Viewed by 2665

Special Issue Editor

Prof. Dr. Michael Gnant

grade E-Mail Website
Guest Editor
Breast Health Center, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
Interests: cancer; breast cancer; endocrine therapy; CDK4/6 inhibitors; aromatase inhibitors; tamoxifen; ovarian function suppression; SERDs; dormancy

Special Issue Information

Dear Colleagues,

Hormone-receptor-positive and HER2-negative breast cancer is the most common type of breast cancer. Endocrine therapy is the mainstay of treatment, and many patients do not need any other treatment. In both advanced and early cancer, additional therapies aiming at overcoming resistance have been developed. The emergence of novel targeted therapy in combination with endocrine therapy has shown improvement in outcomes, and may even make cytotoxic chemotherapy unnecessary in more patients in the future. In particular, CDK4/6 inhibitors and novel SERDs are promising options for the future. In this Special Issue of Cancers, we welcome original research and comprehensive review articles focusing on recent developments in the treatment of hormone-receptor-positive breast cancer, including special topics such as premenopausal patients and neoadjuvant treatment approaches.

Prof. Dr. Michael Gnant
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • hormone receptor-positive
  • tamoxifen
  • ovarian function suppression
  • aromatase inhibitors
  • SERDs
  • CDK4/6 inhibitors
  • PI3K
  • clinical trials

Published Papers (2 papers)

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Review

13 pages, 279 KiB  
Review
The Use of Cyclin-Dependent Kinase 4/6 Inhibitors in Elderly Breast Cancer Patients: What Do We Know?
by Alexandre Giraudo, Renaud Sabatier, Frederique Rousseau, Alexandre De Nonneville, Anthony Gonçalves, Maud Cecile, Cecile Braticevic, Frederic Viret, Lorene Seguin, Maria Kfoury, Dorothée Naudet, Marie Hamon and Louis Tassy
Cancers 2024, 16(10), 1838; https://doi.org/10.3390/cancers16101838 - 11 May 2024
Viewed by 512
Abstract
Background: Breast cancer (BC) incidence increases with age, particularly in HR-positive/HER2-negative subtypes. Cyclin-dependent kinase 4 and 6 inhibitors (CDK 4/6is) alongside endocrine therapy (ET) have emerged as promising treatments for HR-positive/HER2-negative advanced and early BC. However, their efficacy, safety, and impact on quality [...] Read more.
Background: Breast cancer (BC) incidence increases with age, particularly in HR-positive/HER2-negative subtypes. Cyclin-dependent kinase 4 and 6 inhibitors (CDK 4/6is) alongside endocrine therapy (ET) have emerged as promising treatments for HR-positive/HER2-negative advanced and early BC. However, their efficacy, safety, and impact on quality of life (QoL) in older and frail patients remain underexplored. Methods: This position paper assesses the existing literature from 2015 to 2024, focusing on CDK4/6is use in patients aged 65 years and older with HR-positive/HER2-negative BC. Results: Our analysis methodically addresses critical questions regarding the utilization of CDK4/6is in the elderly BC patient population, organizing findings from the metastatic and adjuvant settings. In the metastatic setting, CDK4/6is significantly improve progression-free survival (PFS), paralleling benefits observed in younger patients, and suggest potential overall survival (OS) benefits, warranting further investigation. Despite an increased incidence of grade ≥ 3 adverse events (AEs), such as neutropenia and asthenia, CDK4/6is present a markedly lower toxicity profile compared to traditional chemotherapy, with manageable side effects. QoL analysis indicates that integrating CDK4/6is into treatment regimens does not significantly impact elderly BC patients’ daily life and symptom management. Special attention is given to frail subgroups, and personalized approaches are recommended to balance efficacy and adverse effects, such as starting with ET alone and introducing CDK4/6is upon progression in patients with a low disease burden. Transitioning to the adjuvant setting, early results, particularly with abemaciclib, indicate positive effects on disease-free survival (DFS), emphasizing the need for continued analysis to validate these findings and assess long-term implications. However, data on older patients are insufficient to conclude whether they truly benefit from this treatment. Conclusion: Overall, CDK4/6is present a favorable benefit-risk profile in older BC patients, at least in advanced BC; however, further research is warranted to optimize treatment strategies and improve outcomes in this population Full article
(This article belongs to the Special Issue State-of-the-Art and Perspectives in the Treatment of Hormone-Receptor-Positive Breast Cancer)
12 pages, 507 KiB  
Review
Extended Adjuvant Endocrine Therapy in Early Breast Cancer Patients—Review and Perspectives
by Inga Bekes and Jens Huober
Cancers 2023, 15(16), 4190; https://doi.org/10.3390/cancers15164190 - 21 Aug 2023
Cited by 3 | Viewed by 1732
Abstract
Seventy percent of all breast cancer subtypes are hormone receptor-positive. Adjuvant endocrine therapy in these patients plays a key role. Despite the traditional duration of a 5-year intake, the risk of relapse remains elevated in a substantial proportion of patients. Several trials report [...] Read more.
Seventy percent of all breast cancer subtypes are hormone receptor-positive. Adjuvant endocrine therapy in these patients plays a key role. Despite the traditional duration of a 5-year intake, the risk of relapse remains elevated in a substantial proportion of patients. Several trials report that the risk of late recurrence is reduced by the extension of adjuvant endocrine therapy beyond 5 years. However, the optimal duration of endocrine therapy is still a matter of debate. The newer data only show a marginal benefit resulting from extension beyond 7 to 10 years. Furthermore, extension may be associated with more side effects. Thus, the adequate selection of patients qualifying for an extended adjuvant therapy is of importance. Tools/genomic tests, which include the characteristics of the patient and the tumor, may help to better identify patients with a risk of a late relapse. Taken together, the magnitude of benefit for extended adjuvant endocrine therapy is based on the precise estimation of the risk of relapse after 5 years. This must be balanced against the long-term side effects of endocrine treatment and the competing risks. For patients with an intermediate risk, 7 years appears to be the optimal duration, and in those with high-risk features, endocrine therapy up to 10 years may be considered. Full article
(This article belongs to the Special Issue State-of-the-Art and Perspectives in the Treatment of Hormone-Receptor-Positive Breast Cancer)
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