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<p>Hormone receptor-positive/HER2-negative breast cancer is the most common type of breast cancer. Despite initial treatment being curative in most cases, up to 26% of patients develop metastases during the course of the disease; approximately 6–10% of patients present with metastatic disease at the time of initial breast cancer diagnosis. The standard first-line treatment in the absence of visceral crisis is a&#xa0;combination of endocrine therapy and CDK4/6 inhibitor, which shows significant advantages in progression-free survival and, in some cases, overall survival. The choice of CDK4/6 inhibitor requires individual side effect and monitoring management. In cases of early progression and <i>PIK3CA</i> mutation, inavolisib in combination with palbociclib and fulvestrant has been available since 2025. After progression under CDK4/6&#xa0;therapy, other targeted options (e.g. capivasertib, poly(ADP-ribose) polymerase [PARP] inhibitors, elacestrant) can be considered. In cases of endocrine resistance, antibody–drug conjugates and chemotherapy are becoming increasingly important. Key challenges remain the individualisation of therapy, side effect management and the early integration of palliative aspects to ensure quality of life.</p>

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Management des metastasierten Hormonrezeptor-positiven/HER2-negativen Mammakarzinoms

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Elena Laakmann,
  • Volkmar Müller

摘要

Hormone receptor-positive/HER2-negative breast cancer is the most common type of breast cancer. Despite initial treatment being curative in most cases, up to 26% of patients develop metastases during the course of the disease; approximately 6–10% of patients present with metastatic disease at the time of initial breast cancer diagnosis. The standard first-line treatment in the absence of visceral crisis is a combination of endocrine therapy and CDK4/6 inhibitor, which shows significant advantages in progression-free survival and, in some cases, overall survival. The choice of CDK4/6 inhibitor requires individual side effect and monitoring management. In cases of early progression and PIK3CA mutation, inavolisib in combination with palbociclib and fulvestrant has been available since 2025. After progression under CDK4/6 therapy, other targeted options (e.g. capivasertib, poly(ADP-ribose) polymerase [PARP] inhibitors, elacestrant) can be considered. In cases of endocrine resistance, antibody–drug conjugates and chemotherapy are becoming increasingly important. Key challenges remain the individualisation of therapy, side effect management and the early integration of palliative aspects to ensure quality of life.