S15 Ep30: Medical Crossfire®: Mastering the Nuances of Early-Stage HR+/HER2- Breast Cancer—Expert Perspectives on Applying Modern Treatment Paradigms

Management of early-stage hormone receptor-positive HER2-negative breast cancer increasingly integrates CDK4-6 inhibitors, PARP inhibitors, and immune checkpoint inhibitors to improve long-term survival. Clinical trials like Monarch-E and NATALI demonstrate that adjuvant CDK4-6 inhibition provides a sustained invasive disease-free survival benefit, with recent data confirming an overall survival advantage for Abemaciclib. For BRCA-mutated patients, adjuvant Olaparib offers significant risk reduction, though its administration requires careful coordination with other therapies to manage overlapping toxicities. Furthermore, immune checkpoint inhibitors such as Pembrolizumab and Nivolumab enhance pathologic complete response rates in high-risk, treatment-naive patients, showing efficacy even in tumors with lower PD-L1 expression. These therapeutic advancements underscore the necessity of tailoring systemic treatments based on tumor biology, risk profiles, and specific genetic markers to optimize outcomes in high-risk breast cancer populations.